晚期胃癌DCF方案与ECF方案治疗的Meta分析

目的 比较DCF方案（多西他赛、顺铂和5-Fu）与ECF（表阿霉素、顺铂和5-Fu）方案治疗晚期胃癌的有效性与安全性。方法 计算机检索PubMed、CNKI、CBM 、Medalink和万方数据库以及Google学术搜索、手工检索，查找所有比较DCF方案与ECF方案治疗晚期胃癌疗效的随机对照实验(RCT)，依据 Cochrane Handbook 5.0.1 的质量评价标准进行RCT筛选、资料提取和质量评价后,按Cochrane 协作网推荐的方法使用RevMan 5.0 软件对相关病例对照研究进行Meta分析。结果 纳入7项合格研究，共 463例患者，Meta分析结果显示：DCF方案治疗晚期胃癌的有效率明显高于ECF方案OR=1.72, 95%CI(1.18~2.52), P=0.005]，差异具有统计学意义；两方案治疗晚期胃癌的周围神经毒性发生率差异具有统计学意义OR=39.43, 95%CI(12.33~126.13), P<0.00001]。而在3~4度白细胞减少发生率以及3~4度恶心、呕吐发生率方面差异无统计学意义，大多在预防处理后可耐受。结论 DCF方案治疗晚期胃癌的有效率、周围神经毒性发生率均高于ECF方案，不良反应可耐受。

Docetaxel,Cisplatin and 5-fluorouracil (DCF) Compared with Epirubicin,Cisplatin and#br# 5-fluorouracil (ECF) Regimens for Advanced Gastric Cancer: A Meta-analysis

Objective To evaluate the effect and toxicity of docetaxel, cisplatin, and 5-fluorouracil(DCF)compared with epirubicin, cisplatin, 5-fluorouracil(ECF) regimens for advanced gastric cancer.Methods PubMed, CNKI, CBM, Medalink and Wanfang database, and Google Scholar search, manualsearch were applied to select relative randomized controlled trials (RCT) of DCF and ECF regimens.Literatures were screened according to Cochrane Handbook 5.0.1 quality evaluation criteria. Metaanalysiswas conducted with RevMan 5.0 software according to the methods recommended by theCochrane Collaboration. Results Seven qualified researches involving 463 patients were included. Metaanalysisshowed DCF was significantly higher than ECF for advanced gastric cancer in overall responserateOR=1.72,95%CI (1.18-2.52), P=0.005] and incidence of peripheral neuritis OR=39.43,95%CI(12.33-126.13), P<0.00001]. While, there was no statistically significant difference in the incidence of grades 3-4neutropenia, nausea or vomiting. Most of these symptoms could be tolerated after prevention treatment.Conclusion The overall response rate and incidence of peripheral neuritis of DCF are higher than those ofECF for advanced gastric cancer, with tolerable adverse reactions.