摘要
目的:评价卡培他滨联合奥沙利铂或顺铂与替吉奥联合奥沙利铂或顺铂治疗晚期胃癌的有效性和安全性。方法:采用计算机检索Cochrane Library、Pubmed、Embase、中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)、万方数据库,对符合纳入标准的随机对照试验(RCT)进行质量评价和Meta分析。结果:共纳入14项RCT,合计1051例患者。卡培他滨化疗组和替吉奥化疗组的总有效率、完全缓解率和部分缓解率的差异均无统计学意义(P>0.05)。安全性方面,卡培他滨化疗组手足综合征的发生率高于替吉奥化疗组[RR=2.59,95%CI(1.61,4.17),P<0.0001],而口腔黏膜炎的发生率低于替吉奥化疗组[RR=0.64,95%CI(0.50,0.82),P=0.0004]。恶心呕吐、腹泻、神经毒性、肝脏毒性、肾脏毒性、贫血、白细胞减少、中性粒细胞减少和血小板减少等不良反应的发生率两组的差异均无统计学意义(P>0.05)。结论:卡培他滨联合铂类与替吉奥联合铂类治疗晚期胃癌的有效性相似,但卡培他滨联合铂类更易引起手足综合征,而替吉奥联合铂类更易引起口腔黏膜炎。
Objective：To evaluate the efficacy and safety of capecitabine or S-1 combined with oxaliplatin or cisplatin in the treat-ment of advanced gastric cancer. Methods：Six databases including Cochrane Library, Pubmed, Embase, CNKI, VIP and WanFang were retrieved. Randomized controlled trials （ RCT） in the treatment of advanced gastric cancer were involved for the quality assess-ment and Meta-analysis. Results：A total of 14 RCT involving 1 051 patients were included. There were no significant differences in the total effective rate, complete remission rate and partial remission rate between the two groups（P〉0. 05）. In the safety evaluation, the incidence of hand-foot syndrome was higher in capecitabine-based regimens than that in S-1-based regimens[RR=2. 59,95%CI （1. 61,4. 17）,P〈0. 000 1], while the incidence of stomatitis was lower in capecitabine-based regimens[RR=0. 64,95%CI（0. 50, 0. 82）,P=0. 000 4]. The other adverse reactions such as nausea and vomiting, diarrhea,neuropathy,dysfunction of liver and kidney, anemia, leukopenia, neutropenia and thrombocytopenia exhibited no significant differences between the two groups（P〉0. 05）. Con-clusion：Capecitabine combined with oxaliplatin or cisplatin has similar efficacy with S-1 combined with oxaliplatin or cisplatin in the treatment of advanced gastric cancer, and the incidence of hand-foot syndrome is higher in capecitabine-based regimens and the inci-dence of stomatitis is higher in S-1-based regimens.
出处
《中国药师》
CAS
2014年第10期1707-1713,共7页
China Pharmacist
基金
科技部国家科技支撑计划子课题(编号:2013BAI06B04)
上海医院药学科研基金(编号:2012-YY-01-05)
