含多西他赛的新辅助化疗治疗进展期胃癌有效性和安全性的Meta分析

Effectiveness and safety of neoadjuvant chemotherapy containing docetaxel in treatment of advanced gastric cancer:a Meta-analysis

目的：评价包含多西他赛的新辅助化疗方案在进展期胃癌治疗中的有效性和安全性。方法：计算机检索多个国内外数据库收集相关文献，按文献纳入与排除标准，筛选出符合要求的随机对照试验（RCT）文献，提取相关数据并进行文献质量评估，应用RevMan5．3软件进行Meta分析。结果：总共纳入10篇RCT文献，共计845例患者。Meta分析整体结果显示，试验组（含多西他赛的新辅助化疗联合手术）的R。切除率（OR=1．90，95％CI=1．28-2．81，P=0．001）及临床有效率（OR=1．92，95％CI=1．05-3．51，P=0．03）均高于对照组（单纯手术或不含多西他赛的新辅助化疗联合手术），而两组手术切除率（OR=1．59，95％CI=0．93-2．73，P=0．09）及术后并发症发生率（OR=1．01，95％CI=0．65-1．59，P=0．95）差异均无统计学意义；亚组分析结果显示，含多西他赛的新辅助化疗联合手术组与不含多西他赛的新辅助治疗联合手术组间R0切除率无统计学差异（P〉0．05）。结论：含多西他赛的新辅助化疗方案在不增加术后并发症发生率的同时，可提高进展期胃癌根治性手术切除率及临床有效率，表现出较好的安全性和有效性。

Objective： To evaluate the effectiveness and safety of neoadjuvant chemotherapy containing docetaxel in treatment of advanced gastric cancer. Methods： The relevant literature was collected by searching several national and international databases. According to the indusion and exclusion criteria, the eligible randomized controlhd trials （RCTs） were selected. After data extraction and the quality assessment, Meta-analysis was performed by using RevMan 5.3 software. Results： A total of 10 RCTs was included involving 845 patients. Results of Meta-analysis for overall groupshowed that in study group （undergoing neoadjuvant chemotherapy containing docetaxel combined with surgery） compared with control group （undergoing surgery only or neoadjuvant chemotherapy without docetaxel combined with surgery）, the Ro resection rate （OR=1.90, 95% CI=1.28-2.81, P=0.001） and overall response rate （0R=1.92, 95% CI=1.05-3.51, P=0.03） were significantly increased, while no statistical difference was noted in surgical resection rate （OR=1.59, 95% CI=0.93-2.73, P=0.09） and incidence of postoperative complications （OR=1.01, 95% CI=0.65-1.59, P=0.95）; results of subgroup analysis showed that the Ro resection rate had no statistical difference between patients undergoing preoperative neoadjuvant chemotherapy containing docetaxel and those undergoing preoperative neoadjuvant chemotherapy without docetaxel （P〉0.05）. Conclusion： Neoadjuvant chemotherapy containing docetaxel can improve the radical resection rate and overall response rate without increase of complications, so it has better efficacy and safety.