靶向药物联合吉西他滨和吉西他滨单药化疗治疗晚期胰腺癌比较的Meta分析

目的 通过Meta分析探讨靶向药物联合吉西他滨和吉西他滨单药化疗在治疗晚期胰腺癌病人中的意义。方法 通过MEDLINE、EBM等数据库，检索国内外已发表和已注册但未发表的相关文献。选择的治疗组为吉西他滨联合靶向药物，对照组为吉西他滨单药化疗的晚期胰腺癌的随机对照实验。由2位评价者分别按上述检索策略收集资料、按选择标准入选。主要对半年生存率、1年生存率、客观缓解率和毒副反应进行Meta分析。结果 在治疗晚期胰腺癌方面，吉西他滨联合靶向药物和吉西他滨单药比较，半年生存率提高4％(P=0．27)，1年生存率提高3％(P=0．34)，客观缓解率降低了3％(P=0．17)，差异均无统计学意义。毒副反应方面，吉西他滨联合靶向药物和吉西他滨单药比较，3／4度中性粒细胞减少的发生率增加了2％(P=0．84)，差异无统计学意义，3／4度贫血发生率无变化(P=0．96)，3／4度恶心 呕吐的发生率减少了6％(P=0.02)，差异有统计学意义。结论 靶向药物联合吉西他滨不适合用于晚期胰腺癌，目前尚不推荐临床常规使用。

A meta-analysis of Gemcitabine and targeted agents with Gemcitabine and placebo in inoperable pancreatic cancer

Objectives To compare Gemcitabine and targeted agents with Gemcitabine and placebo in inoperable pancreatic cancer through meta-analysis. Methods MEDLINE and EBM searches were supplemented by information from trial registers. RCT(randomized clinical trial) for Gemcitabine and targeted agents with Gemcitabine and placebo. A quantitative meta-analysis using updated information based on inclusion criterion from all available RCT was carried out by two reviewers. The meta-analysis was based on response rates,6-month survival,1-year survival and toxicity. Results Comparing Gemcitabine and targeted agents with Gemcitabine and placebo, 4% relative increase was obtained on 6-month survival(P=0.27), 3% relative increase was obtained on 1-year survival(P=0.34), 3% relative decrease was obtained on objective response rates(P=0.17). But all of the results have no significant difference. In terms of toxicity, 6% relative decrease was obtained on WHO grade 3/4 vomiting+nausea(P=0.02),The other toxicities show no significant difference in two groups. Conclusion Gemcitabine combined with targeted agents can not be recommended as therapy for inoperable pancreatic cancer at present.