晚期胃癌不同化疗方案的系统评价

目的 系统评价晚期胃癌化疗方案中含多西他塞方案与含表柔比星方案有效性及安全性差异.方法 在CNKI、万方、维普、PubMed、embase数据库中检索晚期胃癌中含多西他塞方案与含表柔比星方案对比的随机临床对照试验.采用Jadad评分标准对已检索到的文献进行筛选及评价,确定纳入研究的文献.采用Stata12.0软件进行数据统计并绘制森林图,系统评价其有效性及安全性.结果 含多西他塞方案总缓解率(ORR)优于含表柔比星方案(RR=1.24,95%CI:1.03~1.49).在神经毒性方面,含多西他塞方案发生率更高(RR=3.92,95%CI:1.31~11.69),在血小板减少方面,含表柔比星方案发生率更高(RR=0.69,95%CI:0.50~0.95).在白细胞减少、贫血及恶心、呕吐等方面,两组的发生率差异无统计学意义.结论 晚期胃癌联合化疗方案中,含多西他塞方案总缓解率优于含表柔比星方案.

Systematic evaluation of different chemotherapy regimens for patients with advanced gastric cancer

Objective To evaluate the efficacy and safety of Docetaxel versus Epirubicin for advanced gastric cancer. Methods CNKI, Wanfang database, VIP, PubMed, Embase were searched for relative randomized controlled trials (RCT) of treating advanced gastric cancer with Docetaxel or Epirubicin regimen. The retrieved literatures were screened and evaluated by Jadad score criteria. Stata12.0 was used for statistical analysis and forest plots. The efficacy and safety indicators such as overall response rate, hematological toxicity, neurotoxicity and gastrointestinal toxicity were evaluated systematically. Results In aspect of efficacy, the overall response rate for Docetaxel regimen was signif-icantly higher than that for Epirubicin regimen group (RR=1.24, 95%CI:1.03~1.49). In terms of safety, the incidence of neurotoxicity for Docetaxel regimen was significantly higher than that for Epirubicin regimen (RR=3.92, 95%CI:1.31~11.69), but the incidence of thrombocytopenia for Docetaxel regimen was significantly lower than that for Epirubicin reg-imen (RR=0.69, 95%CI:0.50~0.95). There was no statistically significant difference between the two regiments in the in-cidences of leucopenia, anemia, nausea and vomiting. Conclusion The overall response rate for Docetaxel regimen is significantly higher than that for epirubicin regimen in the treatment of advanced gastric cancer.