进展期胃癌S-1与5-FU基础化疗有效性和安全性Meta分析

发布时间：2018-05-09 15:48

本文选题：进展期胃癌 + S-　；参考：《中华肿瘤防治杂志》2017年07期

【摘要】：目的 S-1被应用于进展期胃癌一线化疗中,其疗效也备受关注。本研究评估S-1基础化疗对比5-氟尿嘧啶(5-Fluorouracil,5-FU)基础化疗方案在进展期胃癌一线化疗中的有效性和安全性。方法用"胃癌、替吉奥或S-1、5-氟尿嘧啶和随机对照研究"等检索词,在Pubmed、Embase、Cochrane Library、ASCO会议摘要、中国生物医学文献数据库(CBM)、相关期刊论文(CNKI)和中文科技期刊全文数据库(VIP)等检索相关的临床随机对照试验,检索时间截止至2016-10。提取总生存期、无疾病进展生存期、有效率、3~4级不良反应等数据。采用Revman 5.3和STATA 12.0进行数据分析。结果共纳入18个随机对照研究,3 581例患者。结果显示,S-1基础化疗在总生存期(HR=0.92,95%CI为0.84~1.01,P=0.07)及无疾病进展生存期(HR=0.90,95%CI为0.76~1.07,P=0.25)方面与5-FU基础化疗方案差异无统计学意义,但有更高的有效率,RR=1.46,95%CI为1.22~1.74,P0.001。S-1基础化疗方案3~4级中性粒细胞减少(P0.001)、白细胞减少(P0.001)、血小板减少(P=0.01)、口腔炎(P0.001)和脱发(P=0.02)等不良反应较5-FU基础化疗发病率更低,差异有统计学意义。结论相比于5-FU基础化疗,S-1基础化疗在进展期胃癌一线治疗中均是有效且更安全的化疗方案。
[Abstract]:Objective: s-1 has been used in the first-line chemotherapy of advanced gastric cancer, and its curative effect has been paid more attention. This study was to evaluate the efficacy and safety of S-1 basic chemotherapy regimen compared with 5-Fluorouraciline 5-FU regimen in primary chemotherapy for advanced gastric cancer. Methods with the key words of "gastric cancer, tigueo or S-1 5-fluorouracil and randomized controlled study", the Abstract of ASCO meeting was performed in Pubmedus Embase Cochrane Library. Chinese Biomedical Literature Database (CBMN), Chinese Journal Full-text Database (CNKI) and Chinese Sci-tech Journal Full-text Database (VIP) have been used in clinical randomized controlled trials. The retrieval time is up to 2016-10. Total survival time, no disease progression survival time, and effective rate of grade 4 adverse reactions were extracted. The data were analyzed by Revman 5.3 and STATA 12.0. Results A total of 3 581 patients were enrolled in 18 randomized controlled trials. The results showed that there was no significant difference between the basic chemotherapy regimen and the basic chemotherapy regimen of 5-FU in the total survival time (CI = 0.84) and the progression free survival time (CI = 0.761.07) and the CI value of 0.92 / 95 (CI = 0.84 / 1.01) and 0.9095% (CI = 0.761.07), respectively. However, there was a higher effective rate of adverse reactions such as RRN 1.46C 95 CI 1.22 + 1.74U P0.001.S-1 basic chemotherapy regimen 3nb. 001N, leukopenia P0.001g, thrombocytopenia P0.01m, stomatitis P0.001) and alopecia P0.02). The difference was statistically significant. Conclusion compared with 5-FU basic chemotherapy, S-1 is an effective and safer regimen in the treatment of advanced gastric cancer.
【作者单位】：昆明医科大学第一附属医院胃肠外科;昆明医科大学第一临床学院;
【基金】：云南省卫生厅内设机构项目(2014NS122;2014NS124) 云南省教育厅科学研究基金(2015N54)
【分类号】：R735.2

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