FOLFOX方案与XELOX方案治疗中晚期结肠癌患者疗效和安全性的meta分析

Meta analysis of efficacy and safety of FOLFOX regimen and XELOX regimen in patients with advanced colon cancer

目的评价FOLFOX方案与XELOX方案治疗中晚期结肠癌的疗效和安全性。方法通过计算机检索维普数据库、中国生物医学文摘数据库、中国知网、万方数据与PubMed等数据库,采用RevMan 5.3软件对符合纳入标准的临床研究进行质量评价与meta分析。结果本研究共纳入12篇文献,共1614例结肠癌患者,FOLFOX组801例,XELOX组813例。Meta分析显示两种方案在总体应答率、完全应答率、部分应答率、总体生存率、无病进展存活率上差异均无统计学意义;Ⅲ/Ⅳ级不良反应中XELOX方案导致的手足综合征发生率高于FOLFOX方案(RR=0.2,95%CI0.08~0.51,P<0.001),而FOLFOX方案导致的Ⅲ/Ⅳ级中性粒细胞减少症高于XELOX方案(RR=5.47,95%CI3.42~8.76,P<0.001)。结论FOLFOX方案与XELOX方案在治疗中晚期结肠癌方面的疗效相似,但需要注意XELOX方案具有较易发生Ⅲ/Ⅳ级手足综合征的风险,而FOLFOX方案则具有相对易发生Ⅲ/Ⅳ级中性粒细胞减少症的风险。

Objective To evaluate the efficacy and safety of FOLFOX regimen and XELOX regimen in the treatment of advanced colon cancer. Methods The following five databases were searched: VIP Database, Chinese BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and PubMed.The quality assessment and meta analysis of the clinical studies meeting the inclusion criteria were performed using RevMan 5.3 software. Results A total of 12 articles were included in the study, with 1 614 colon cancer patients, 801 to the FOLFOX group and 813 to the XELOX group.There was no significant difference in overall response, complete response, partial response, overall survival, and progression-free survival between the two regimens.The incidence rate of grade Ⅲ/Ⅳ hand-foot syndrome caused by XELOX regimen (RR=0.2, 95% CI 0.08-0.51, P < 0.001 ) was higher than that by FOLFOX regimen, while the grade Ⅲ/Ⅳ neutropenia caused by FOLFOX regimen (RR= 5.47, 95%CI 3.42-8.76, P <0.001) was higher than that by XELOX regimen. Conclusion The efficacy of FOLFOX regimen on advanced colon cancer is similar to that of XELOX regimen, but it is worth noting that the risk of grade Ⅲ/Ⅳ hand-foot syndrome caused by XELOX regimen is higher, while the risk of grade Ⅲ/Ⅳ neutropenia caused by FOLFOX regimen is higher.