吉西他滨单药或联合白蛋白结合型紫杉醇治疗东亚人群晚期胰腺癌临床疗效的荟萃分析

目的系统评价吉西他滨单药和吉西他滨联合白蛋白结合型紫杉醇一线治疗东亚人群晚期转移性胰腺癌的疗效,以期为中国转移性胰腺癌临床一线治疗的合理用药提供依据。方法按照预设的纳入和排除标准,在万方、Cochran Library、MEDLINE、PubMed和CNKI等数据库中系统性检索2010年1月至2018年6月发表的文献。主要观察终点为客观缓解率(ORR),次要终点为无进展生存期(PFS)和总生存期(OS)。提取纳入文献的相关资料,采用Rav Man 3. 5. 0版软件进行Meta分析。结果共纳入38项研究,合计1945例患者。吉西他滨单药治疗晚期胰腺癌的ORR为0. 15(95%CI:0. 11～0. 18)、中位PFS为3. 39(95%CI:2. 74～4. 05)个月、中位OS为7. 39(95%CI:6. 54～8. 23)个月;吉西他滨联合白蛋白结合型紫杉醇治疗晚期胰腺癌的ORR为0. 40(95%CI:0. 29～0. 52)、中位PFS为5. 68(95%CI:4. 30～7. 06)个月、中位OS为9. 80(95%CI:7. 89～11. 71)个月。结论吉西他滨联合白蛋白结合型紫杉醇与吉西他滨单药比较,具有明显的优效性,适合东亚人群,特别是中国晚期胰腺癌患者。

The meta-analysis of clinical efficacy of gemcitabine monotherapyand gemcitabine combined with nab-paclitaxel for East Asian patients withadvanced stage pancreatic adenocarcinoma

Objective To systematicallyevaluate the efficacy of gemcitabine monotherapy and gemcitabine combined withnab-paclitaxel in the first-line treatment of advanced metastatic pancreaticcancer in East Asian population， inorder to provide a reference for the clinical rational use of gemcitabine inthe first-line treatment of patients with metastatic pancreatic cancer inChina. Methods According to the preset inclusion and exclusion criteria， literatures published from January 2010 to June 2018 weresystematically searched in Wanfang， Cochran Library， MEDLINE， PubMed and CNKI databases. The primary endpoint was objectiveremission rate （ORR）， and the secondary endpoint was progression-free survival （PFS） andoverall survival （OS）. Then the related data was extracted and meta-analysis wasperformed by using Rev Man 3.5.0 statistical software. Results A total of 38studies involving 1945 patients were included. The ORR of gemcitabinemonotherapy for advanced pancreatic cancer was 0.15 （95％ CI： 0.11-0.18）， themedian PFS was 3.39 （95％ CI： 2.74-4.05） months， and themedian OS was 7.39 （95％ CI： 6.54-8.23） months. The ORR of gemcitabine combined with nab-paclitaxel in thetreatment of advanced pancreatic cancer was 0.40 （95％ CI： 0.29-0.52）， themedian PFS was 5.68 （95％ CI： 4.30-7.06） months， and themedian OS was 9.80 （95％ CI： 7.89-11.71） months. Conclusion Compared with gemcitabine monotherapy， gemcitabine combined with albumin-bound paclitaxel has obvioussuperiority and is suitable for East Asian population， especially for patients with advanced pancreatic cancer in China.