XELOXs方案与FOLFOXs方案在中国进展期胃癌患者中疗效及不良反应的Meta分析

A meta-analysis:The efficacy and adverse reactions of XELOXs and FOLFOXs scheme in advanced gastric cancer in China

目的系统评价XELOXs方案与FOLFOXs方案在治疗进展期胃癌中的疗效及不良反应。方法在万方、维普、CNKI、Pub Med数据库中检索XELOXs和FOLFOXs方案治疗进展期胃癌的前瞻性临床对照试验研究,对纳入研究进行质量评价,采用Rev Man 5.3进行Meta分析。结果纳入12篇文献,共计825例患者。XELOXs组有效率较FOLFOXs组高(RR=1.18,95%CI:1.04~1.36,P=0.01);XELOXs方案胃肠道反应(RR=0.47,95%CI:0.39~0.57)、血小板减少(RR=0.64,95%CI:0.47~0.87)、腹泻(RR=0.59,95%CI:0.44~0.79)、白细胞减少(RR=0.53,95%CI:0.38~0.75)的发生率较FOLFOXs组低(P<0.05),手足综合症的发生率较FOLFOXs组高(RR=3.22,95%CI:0.90~11.51;P<0.00001)。XELOXs组不同累计治疗量间的疗效差异无统计学意义(P=0.125);高计量组神经毒性(P=0.002)、白细胞减少(P=0.020)、血小板较少(P=0.000)发生率高于其它两组。结论在治疗进展期胃癌中,XELOXs方案疗效优于FOLFOXs方案;XELOXs方案不同累计治疗剂量间疗效无差异,且不良反应发生率随剂量增高而增高。

Objective： To evaluate the efficacy and adverse reactions of XELOXs and FOLFOXs in the treatment of advanced gastric cancer in China.Methods A computer-based online search of Wanfang Data, CNKI, PubMed was performed. In accordance with the inclusion and exclusion criteria, the randomized controlled trails（RCTs） were selected. After evaluating the quality of included studies and extracting the data, a Meta-analysis was performed by using RevMan 5.3. Results A total of 12 articles with 825 patients were included in this Meta-analysis. The effective rate of XELOXs group_was higher than FOLFOXs （RR = 1.18, 95% CI： 1.04 - 1.36; P=0.01）. The incidence of gastrointestinal reactions （RR=0.47, 95% CI： 0.39 0.57）, thrombocytopenia （RR=0.64, 95% CI： 0.47 - 0.87）, diarrhea （RR=0.59, 95% CI： 0.44 0.79）, leukopenia （RK=0.53, 95% CI： 0.38 0.75） in XELOXs group were lower than FOLFOXs group （P 〈 0.05）, while the incidence of hand- foot syndrome was higher （RR, 3.22, 95% CI： 0.90 ll.51;P〈0.00001）; There was no significant difference in efficacy between the different cumulative therapeutic measures of XELOXs group（P = 0.125）. The incidence of Neurotoxicity（P = 0.002）, leukopenia （P = 0.020）, platelet （P = 0.000） in high cumulative treatment group was higher. Conclusion The XELOXs was superior to the FOLFOXs in the treatment of advanced gastric cancer. There was not statistically different for the effective rate of different dose in XELOXs.