替吉奥联合奥沙利铂对比替吉奥联合顺铂治疗晚期胃癌的Meta分析

目的评价替吉奥联合奥沙利铂（SOX方案）对比替吉奥联合顺铂（SP方案）治疗晚期胃癌（AGC）的疗效及安全性。 方法在PubMed、Embase、Web of Science、中国期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）、万方数据库、维普中文科技期刊数据库中检索2022年7月前公开发表的有关替吉奥联合奥沙利铂（SOX组）对比替吉奥联合顺铂（SP组）治疗AGC的相关研究，按照Cochrane Handbook 5.1的临床试验质量评价标准对文献进行质量评价，采用RevMan 5.4软件进行Meta分析。 结果共有14篇2 650例AGC患者纳入研究，其中SOX组1 334例，SP组1 316例。与SP组比较，SOX组的总生存期（HR=0.87，95% CI：0.78~0.97，P=0.01）、无进展生存期（HR=0.87，95% CI：0.78~0.97，P=0.01）、完全缓解（OR=1.43，95% CI：1.02~2.00，P=0.04）、部分缓解（OR=1.64，95% CI：1.18~2.29，P=0.003）、疾病进展（OR=0.55，95% CI：0.34~0.87，P=0.01）、疾病控制率（OR=1.64，95% CI：1.04~2.56，P=0.03）和疾病稳定（OR=0.67，95% CI：0.53~0.83，P=0.000 4）方面比较，差异均有统计学意义，而两组客观有效率差异无统计学意义（OR=1.57，95% CI：0.85~2.90，P=0.15）。安全性方面，3级及以上不良反应中，SOX组白细胞减少（OR=0.20，95% CI：0.13~0.30，P<0.000 01）、贫血（OR=0.52，95% CI：0.32~0.86，P=0.01）、肌酐升高（OR=0.21，95% CI：0.07~0.61，P=0.004）的发生率更低，而周围感觉神经病（OR=10.64，95% CI：1.85~61.10，P=0.008）的发生率更高。 结论SOX方案可提高AGC的治疗有效率，改善无进展生存期和总生存期，但可能增加周围感觉神经病的发生率。

S-1 plus oxaliplatin versus S-1 plus cisplatin in the treatment of advanced gastric cancer: A Meta-analysis

ObjectiveTo compare the efficacy and safety of S-1 plus oxaliplatin (SOX therapy) with S-1 plus cisplatin (SP therapy) for patients with advanced gastric cancer (AGC). MethodsDatabases such as PubMed, Embase, Web of Science, CNKI, Chinese Biomedical Literature Database, Wanfang Data, VIP were searched from the inception to July 2022. Relevant studies were retrieved on the controlled study of S-1 plus oxaliplatin (SOX group) or S-1 plus cisplatin (SP group) for AGC. Quality of the included studies was assessed by the Cochrane Handbook 5.1 tool. Meta-analysis was performed using RevMan 5.4 software. ResultsA total of 14 literatures involving 2 650 patients with AGC were included, with 1 334 patients in the SOX group and 1 316 patients in the SP group. The overall survival (HR=0.87, 95% CI: 0.78-0.97, P=0.01), progression-free survival (HR=0.87, 95% CI: 0.78-0.97, P=0.01), complete response (OR=1.43, 95% CI: 1.02-2.00, P=0.04), partial response (OR=1.64, 95% CI: 1.18-2.29, P=0.003), progress disease (OR=0.55, 95% CI: 0.34-0.87, P=0.01), disease control rate (OR=1.64, 95% CI: 1.04-2.56, P=0.03), and disease stability (OR=0.67, 95% CI: 0.53-0.83, P=0.000 4) in the SOX group were significantly better than those in the SP group. However, there was no statistically significant difference in objective response rate between the two groups (OR=1.57, 95% CI: 0.85-2.90, P=0.15). In terms of safety, the incidence of grade 3 or higher adverse reactions of SOX group was lower in leukopenia (OR=0.20, 95% CI: 0.13-0.30, P<0.000 01), anemia (OR=0.52, 95% CI: 0.32-0.86, P=0.01), creatinine elevation (OR=0.21, 95% CI: 0.07-0.61, P=0.004), but higher than SP group in peripheral sensory neuropathy (OR=10.64, 95% CI: 1.85-61.10, P=0.008). ConclusionSOX therapy can improve the treatment efficiency, progression-free survival and overall survival of AGC, but may increase the incidence of peripheral sensory neuropathy.