血管内皮生长因子抑制剂治疗晚期胃癌的Meta分析

The role of vascular endothelial growth factor inhibitors in the treatment of advanced gastric cancer: a Meta-analysis

目的 研究血管内皮生长因子（VEGF）抑制剂治疗晚期胃癌的效果与安全性。方法 通过检索1990年1月~2015年8月Pub Med、EMBASE、Cochrane Central Register of Controlled Trials、MEDLINE和中国知网等电子数据库,并用Stata 12.0软件对其进行VEGF抑制剂治疗晚期胃癌的随机对照试验研究的Meta分析。结果 纳入7个试验包括2340例患者。与无VEGF抑制剂治疗比较,VEGF抑制剂治疗可以显著改善总生存期（HR=0.71,95%CI：0.54~0.88,P=0.003）、无进展生存期（HR=0.57,95%CI：0.38~0.77,P〈0.001）、总缓解率（RR=1.29,95%CI：1.11~1.47,P〈0.001）;VEGF抑制剂治疗可能发生更多3级以上不良反应。结论VEGF抑制剂治疗可显著改善晚期胃癌患者的总体生存,尤其是较早接受治疗的患者。

Objective To study the effectiveness and security of vascular endothelial growth factor （VEGF） inhibitors in the treatment of advanced gastric cancer. Methods The databases of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, MEDLINE and CNKI from January 1990 to August 2015 were searched. A Meta-analysis of randomized controlled trials （RCTs） was performed to assess the efficacy and safety of VEGF inhibitors in the treatment of ad- vanced gastric cancer by using Stata 12.0. Results Seven RCTs which involved 2340 patients were ultimately enrolled. Compared with the treatment without VEGF inhibitors, the VEGF inhibitors therapy could significantly improve overall survival （HR = 0.71, 95%CI： 0.54-0.88, P = 0.003）, progression free survival （HR = 0.57, 95%CI： 0.38-0.77, P 〈 0.001） and ORR （RR = 1.29, 95%CI： 1.11-1.47, P 〈 0.001）. Additionally, more incidences of grade 3 or 4 of adverse reactions were observed in VEGF inhibitors therapy. Conclusion The VEGF inhibitors therapy can significantly im- prove the overall survival of patients with advanced gastric cancer, especially for the patients receiving treatment early.