华蟾素联合化疗治疗中晚期胃肠道肿瘤的Meta分析

Cinobufotalin combined with chemotherapy for the advanced gastrointestinal cancer: a Meta-analysis

目的 系统回顾华蟾素联合化疗治疗中晚期胃肠道肿瘤的临床疗效与不良反应。方法 通过计算机检索Cochrane Library、Pub Med、CNKI、Sino Med、维普、万方,纳入含华蟾素联合化疗治疗中晚期胃肠道肿瘤的随机对照研究（RCTs）,由2名评价者独立进行文献筛选、资料提取并交叉核对纳入的研究质量,对纳入的同质研究采用Rev Man 5.3进行Meta分析。结果 共纳入19篇（胃癌16篇、结直肠癌3篇）RCTs,共1 319例患者,结果显示：在提高近期有效率、生存质量、缓解化疗引起的疼痛、Ⅲ~Ⅳ度白细胞降低、Ⅱ度及以上骨髓抑制、Ⅲ~Ⅳ度胃肠道反应方面华蟾素联合组优于单纯化疗组,差异有统计学意义（P〈0.05）;但在提高生存率、缓解Ⅰ~Ⅱ度血小板减少方面,华蟾素联合化疗组与单纯化疗组比较,差异无统计学意义（P〉0.05）。结论 华蟾素联合化疗治疗中晚期胃肠道肿瘤近期效果优于单纯化疗,但由于纳入文献质量较低,各研究化疗方法差异较大,尚需科学规范的、大样本、多中心、长期的RCTs进一步验证。

Objective To evaluate the efficacy and safety of Cinobufotalin combined with chemotherapy vs chemo- therapy alone for the advanced gastrointestinal cancer （GC）. Methods Cochrane Library, PubMed, CNKI, SinoMed, VIP, Wanfang datebase and some related journals were searched. Randomized controlled trails （RCTs） about Cinobufo- talin combined with chemotherapy for the advanced GC were included. According to inclusion and exclusion criteria, two reviewers independently selected and assessed the included trials. The Cochrane Collaboration software RevMan 5.3 was used for Meta-analysis. Results A total of 19 RCTs which included 16 terms gastric cancer and 3 terms colorectal cancer were collected, 1 319 patients were included. Results of Meta-analysis demonstrated that Cinobufotalin combined with systematic chemotherapy was superior to chemotherapy alone in the treatment of the advanced GC in respect of ef- fective rate, the quality of life, relief of pain, grade Ⅲ-Ⅳ leukopenia, the Ⅱ ,Ⅲ , Ⅳ degree myelosuppression and grade Ⅲ-Ⅳ gastrointestinal reaction （P 〈 0.05）. There were no statistical significances in improving survival rate and relieving Ⅰ - Ⅱ degree, thrombocytopenia between Cinobufotalin combined with systematic chemotherapy and chemother- apy alone （P 〉0.05）. Conclusion Cinobufotalin is effective for the advanced GC. However, due to limited quantity and quality of the included studies, we can＇ t draw a firm conclusion about the efficacy of Cinobufotalin for GC.