阿帕替尼联合化疗治疗中国人群晚期胃癌的Meta分析

A Meta Analysis: Apatinib Combined With Chemotherapy to Treat the Advanced Gastric Cancer in Chinese Population

目的采用Meta分析的方法探讨阿帕替尼联合化疗治疗晚期胃癌患者的疗效及安全性。方法利用计算机检索中国生物医学文献数据库、中国期刊全文数据库、维普数据库、Cochrane Library、Pub Med、Embase及SCI等数据库,收集阿帕替尼治疗晚期胃癌的临床随机对照试验(randomized control trail,RCT),主要结局指标包括总有效率(overall response rate,ORR)、疾病控制率(disease control rate,DCR)及治疗的相关不良反应,采用Rev Man 5.3软件进行Meta分析。结果共纳入16个随机对照试验,结果显示阿帕替尼联合化疗对比单纯化疗,可以提高ORR(OR=2.03,95%CI:1.50-2.73,P<0.00001)和DCR(OR=2.76,95%CI:1.89-4.04,P<0.00001)。阿帕替尼联合化疗会增加高血压(OR=9.66,95%CI:5.07-18.39,P<0.00001)和蛋白尿(OR=10.25,95%CI:3.78-27.82,P<0.0001)的发生率,但提高患者生活质量(OR=2.15,95%CI:1.29-3.57,P=0.003)。结论阿帕替尼联合化疗治疗晚期胃癌患者可提高患者ORR及DCR,不良反应方面增加了高血压和蛋白尿的发生率,但是提高了患者生活质量。

Objective A Meta-anslysis to evaluate the efficiency and safety of apatinib assisted with chemotherapy in the treatment for advanced gastric cancer. Methods A computer-based on Iine search of Chinese Biomedical Literature Data base, China Academic Journals Fu II-text Database, VIP Database, Cochrane Library, Pub Med, Embase and SCI Data base was performed. Randomized controlled trials（RCT） about apatinib assisted with chemotherapy in the treatment for advanced gastric cancer were collected according to the inclusion criteria. The outcomes included overall response rate（ORR）, disease control rate（DCR） and treatment-related toxicities. The Revman 5.3 software was used for Meta-analysis. Results A total of 16 RCTs were included. 895 patients with advanced gastric cancer were eligible for Meta-analysis. There were statistically significant differences in ORR（OR =2.03, 95%CI ： 1.50-2.73, P 〈 0.00001） and in DCR（OR =2.76, 95%CI ： 1.89-4.04, P 〈 0.00001）. In safety, the incidence of hypertension（OR =9.66, 95%CI ： 5.07-18.39, P 〈 0.00001）and proteinuria（OR =10.25, 95%CI ： 3.78-27.82, P 〈 0.0001）was higher in apatinib and chemotherapy than chemotherapy alone, but the patients‘ quality of life was better（OR =2.15, 95%CI ： 1.29-3.57, P =0.003）.Conclusion Apatinib combined with chemotherapy to treat advanced gastric cancer patients can improve patients ORR and DCR, and increased the adverse reactions of hypertension and proteinuria, and improved the quality of life.