S-1与卡培他滨或氟尿嘧啶治疗晚期结直肠癌的疗效对比Meta分析

Comparison of Efficacy Between S-1 and Capecitabine/Fluorouracil on Advanced Colorectal Cancer: A Meta-analysis

目的利用现有文献资料,对S-1与卡培他滨或氟尿嘧啶治疗晚期结直肠癌的治疗数据进行对比荟萃分析,以此论证S-1替代卡培他滨或氟尿嘧啶的可行性。方法在PubMed、Cochrane Library、Embase、CNKI数据库中检索已发表的文献,在临床试验中心(https://www.clinicaltrials.gov/)中搜寻符合要求的对照试验。资料的提取和质量评价是依据Cochrane Handbook 5.1.0,并使用RevMan 5.3软件对相关病例对照研究进行Meta分析。结果来自11项随机对照研究的3462名患者的数据纳入分析。与卡培他滨或氟尿嘧啶方案相比,S-1治疗组的OS得到改善,但PFS、DCR、ORR并不具有统计学意义。在不良反应中,S-1组的腹泻、肾功能不全和手足综合征的发生率较对照组低。但在合理的对比剂量下S-1组血小板降低的发生率高于对照组。结论晚期结直肠癌的治疗中,S-1替换常规化疗方案中的卡培他滨或氟尿嘧啶有一定的疗效优势。

Objective To conduct a meta-analysis on the data of S-1 and capecitabine or fluorouracil in the treatment of advanced colorectal cancer,to demonstrate the feasibility of S-1 replacing capecitabine or fluorouracil.Methods We searched published literature in the PubMed,Cochrane Library,Embase and CNKI databases,and searched for controlled trials at the Clinical Trials Center(https://www.clinicaltrials.gov/).The data extraction and quality evaluation were conducted according to Cochrane Handbook 5.1.0,and RevMan 5.3 software was used for the meta-analysis of relevant case-control studies.Results The data of 3462 patients from 11 randomized controlled trials were included.Compared with the capecitabine/fluorouracil regimen,OS was improved in the S-1 treatment group,but there was no statistically significant difference in PFS,DCR or ORR.The incidence of diarrhea,renal insufficiency and hand-foot syndrome in the S-1 group was lower than that in the control group.But the incidence of platelet reduction in the S-1 group was higher than that in the control group at a reasonable contrast dose.Conclusion S-1 has a certain therapeutic advantage after replacing capecitabine or fluorouracil in conventional chemotherapy on advanced colorectal cancer.