5-Fu与IFNα-2b联合治疗晚期大肠癌的肿瘤反应率和毒性:6个随机对照临床试验的Meta分析

Tumor Response Rate and Toxicity of Fluorouracil with or Without Interferon Alpha-2b in Patients with Advanced Colorectal Cancer:A Meta-analysis of 6 Randomized Trials

目的 评价IFNα 2b对 5 Fu(或 5 Fu +FA )治疗晚期大肠癌的肿瘤反应率和毒性的颖响。方法 共检索出符合入选标准的 6个随机对照临床试验 ,采用固定效应模型和随机效应模型对 82 6例患者的肿瘤反应率和毒性资料进行Meta分析。结果5 Fu(或 5 Fu +FA ) +IFNα 2b治疗的晚期大肠癌患者的肿瘤反应率较 5 Fu(或 5 Fu +FA )治疗者低 [2 0 .9%∶2 9.7% ,OR =0 .6 6 ,95 %可信限 (CI)为 0 .48～ 0 .91,P =0 .0 1] ;毒性分析表明 ,IFNα 2b加重 5 Fu(或 5 Fu +FA )引起Ⅲ、Ⅳ级血液毒性 (P <0 .0 1)和发热 (P =0 .0 4)的发生。结论 IFNα 2b不仅降低了 5 Fu(或 5 Fu ++FA)治疗晚期大肠癌的疗效 ,而且加重毒性 。

Objective To evaluate tumor response rate and toxicity of fluorouracil(5 Fu) with or without interferon alpha 2b(IFNα 2b) in patients with advanced colorectal cancer.Methods Data of 826 patients in 6 randomized trials were meta analyzed with fixed effect model or random effect model.Results Tumor response rate was significantly lower in patients assigned to 5 Fu(5 FU+FA) and IFNα 2b than in those assigned to 5 Fu(5 FU+FA)(20.9% vs 29.7%,OR=0.66,95%CI,0.48～0.91, P =0.01).Grade 3 or 4 hematologic toxicity( P =0.001)and fever( P =0.04) was all more frequent in patients assigned to 5 Fu and IFNα 2b.Conclusion IFNα 2b significantly decreased efficacy of 5 Fu in advanced colorectal cancer and worsened it's toxicity,so it should not be recommended for routine use.