Meta-analyses of oxaliplatin-based chemotherapy versus cisplatin-based chemotherapy in advanced gastric cancer

目的 系统分析奥沙利铂治疗进展期胃癌的疗效和安全性以及应用前景.方法 通过检索中国数字化期刊全文数据库(CNKI)、万方数据库、维普全文网、美国国家医学图书馆查询系统(PubMed)中近6年来国内外公开发表的文献,收集以奥沙利铂为主的联合方案(试验组)对照顺铂联合方案(对照组)治疗进展期胃癌的临床试验数据,联合药物限定为氟尿嘧啶类(包括卡培他滨)和(或)表阿霉素.使用Review Manager4.2进行有效率、1年生存率、不良反应等方面的荟萃分析.结果 共16篇文献入选,总计2121例胃癌患者,其中试验组1062例,对照组1059例.奥沙利铂为主的联合方案组的有效率(46.3%)较顺铂组(40.6%)高(OR:1.28,P:0.006),1年生存率也高(44.6%比39.3%,OR=1.25,P=0.04);而不良反应中试验组的周围神经毒性的发生率高于对照组(70.6%比21.9%,OR:10.76,P<0.01),贫血(58.0%比70.1%,OR=1.65)和恶心呕吐(61.4%比75.6%,OR=1.32)的发生率则低,差异均有统计学意义(均P<0.05).结论 与既往的顺铂为主的方案相比,奥沙利铂为主的化疗方案在治疗进展期胃癌方面有更好的疗效,相对较安全,患者更易耐受.Objective To analyze whether Oxaliplatin (OXA) is effective in advanced gastric cancer.Methods Clinical trials of OXA-based chemotherapy (treatment group) versus DDP-based chemotherapy (control group) in advanced gastric cancer which published in 6 years were retrieved from China National Knowledge Infrastructure (CNKI),Wanfang Data,VIP information database and PubMed of U.S.National Library of Medicine and NIH.Review Manager 4.2 was used for meta-analysis and main outcome measure ineluded objective response rate.survival and toxicities.Results There were 2121 patients (1062 cases in treatment group and 1059 cases in control group) from 16 controlled clinical trials were enrolled.Response rate increased (46.3% vs 40.6%.OR-1.28,P=0.006)and 1-year survival rate increased (44.6% vs 39.3%,OR=1.25,P=0.04) in treatment group than that of control group.Peripheral neurotoxity was more frequently observed in treatment group (70.6% vs 21.9%,OR=10.76,P<0.01) while anemia and nausea/vomiting were reversed (58.0% vs 70.1%,61.4% vs 75.6% respectively,both P<0.05).Conclusion Oxaliplatin-based chemotherapy is well-tolerated and more effective than cisplatin in advanced gastric cancer.PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)0463261-32658