含多西他赛新辅助化疗治疗进展期胃癌临床疗效的Meta分析

发布时间：2018-11-18 08:27

【摘要】：目的:应用Meta分析评价含多西他赛新辅助化疗方案在进展期胃癌治疗中的有效性和安全性。方法:利用计算机检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据资源库、维普中文期刊数据库、Pubmed、Embase、Cochrane Library等国内外相关数据库,依据文献纳入与排除标准,筛选出含多西他赛新辅助化疗治疗进展期胃癌的相关性临床随机对照试验(RCT)文献,提取有关数据并进行文献质量评估,应用RevMan 5.3软件进行Meta分析。结果:总共纳入14项RCT,共计1106例患者。Meta分析整体结果显示,含多西他赛的新辅助化疗联合手术组的手术切除率[优势比(odds ratio,OR)=1.69,95%可信区间(confidence interval,CI)=1.04~2.77,P=0.04]、根治性手术切除率(OR=2.40,95%CI=1.68~3.43,P0.00001)、临床有效率(OR=1.92,95%CI=1.13~3.25,P=0.02)及2年生存率(OR=2.35,95%CI=1.18~4.67,P=0.01)和3年生存率(OR=1.75,95%CI=1.09~2.81,P=0.02)均高于不含新辅助化疗或不含多西他赛的新辅助化疗联合手术组。两组术后并发症发生率(OR=1.00,95%CI=0.66~1.50,P=0.98)及1年生存率(OR=1.38,95%CI=0.56~3.38,P=0.49)差异均无统计学意义。在手术切除率与根治性手术切除率的亚组分析中,含多西他赛的新辅助化疗联合手术组与不含多西他赛的新辅助化疗联合手术组间也均无统计学差异(P0.05)。结论:含多西他赛新辅助化疗方案在不增加术后并发症发生率的同时,可提高进展期胃癌手术切除率、根治性手术切除率(R0切除率)临床有效率及长期生存率(2年生存率和3年生存率),表现出较好的安全性和有效性。
[Abstract]:Objective: to evaluate the efficacy and safety of adjuvant chemotherapy with docetaxel in the treatment of advanced gastric cancer by Meta analysis. Methods: the Chinese biomedical literature database (CBM), (CNKI), Wanfang data resource database, Weipu Chinese periodical database, Pubmed,Embase,Cochrane Library and other related databases at home and abroad were searched by computer. According to the criteria of literature inclusion and exclusion, the (RCT) literature of the clinical randomized controlled trial of adjuvant chemotherapy containing docetaxel for advanced gastric cancer was selected, and the relevant data were extracted and the literature quality was evaluated. Meta analysis was carried out with RevMan 5.3 software. Results: a total of 1106 patients with 14 items of RCT, were included. The overall results of Meta analysis showed that the resection rate of neo-adjuvant chemotherapy combined with surgery group with docetaxel [odds ratio (odds ratio,OR) = 1.69% 95% confidence interval (confidence interval,] CI = 1.04 + 2.77 P0.04], radical resection rate (OR=2.40,95%CI=1.68~3.43,P0.00001), clinical effective rate (OR=1.92,95%CI=1.13~3.25,P=0.02) and 2-year survival rate (OR=2.35,95%CI=1.18~4.67,) P0. 01) and 3-year survival rate (OR=1.75,95%CI=1.09~2.81,P=0.02) were significantly higher than those without neoadjuvant chemotherapy or docetaxel combined with neoadjuvant chemotherapy. There was no significant difference in incidence of postoperative complications (OR=1.00,95%CI=0.66~1.50,P=0.98) and 1-year survival rate (OR=1.38,95%CI=0.56~3.38,P=0.49) between the two groups. In the subgroup analysis of resection rate and radical resection rate, there was no significant difference between neo-adjuvant chemotherapy combined operation group with docetaxel and neo-adjuvant chemotherapy combined operation group without docetaxel (P0.05). Conclusion: the adjuvant chemotherapy regimen with docetaxel can increase the surgical resection rate of advanced gastric cancer without increasing the incidence of postoperative complications. The clinical effective rate and long-term survival rate (2-year survival rate and 3-year survival rate) of radical resection rate (R0 resection rate) showed good safety and effectiveness.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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