^(125)I粒子联合化疗和单独化疗治疗中晚期胰腺癌 有效性和安全性的Meta分析

Meta-analysis of the efficacy and safety of ^(125)I particles combining with chemotherapy and chemotherapy alone in the treatment of advanced pancreatic cancer

目的评价^(125)I粒子联合化疗和单独化疗治疗中晚期胰腺癌的有效性和安全性。方法检索中国知网、中国生物医学文献数据库(CBM)、万方及维普数据库、PubMed、Embase、Cochrane Library等中外生物医学数据库,收集^(125)I粒子联合化疗和单独化疗治疗中晚期胰腺癌的随机对照试验(RCT),制订文献纳入与排除标准,筛选文献后提取入选文献数据,采用Stata 12.0统计学软件对数据进行分析。结果共纳入10篇文献,共582例患者。^(125)I粒子植入+化疗组患者客观有效率、疼痛缓解率、6个月生存率和12个月生存率均显著优于单纯化疗组(P<0.05);^(125)I粒子植入+化疗组患者的恶心、呕吐等胃肠道不良反应发生率、白细胞及血小板下降等血液系统不良反应发生率、肝功能损害发生率与单纯化疗组比较,差异无统计学意义(P>0.05),但术后胰瘘、胆瘘、腹腔感染、胰腺炎发生率显著高于单纯化疗组(P<0.05)。结论^(125)I粒子联合化疗和单独化疗均能有效治疗晚期胰腺癌,联合方案较单独化疗方案疗效增加,且副作用发生率较低。

Objective To evaluate the effectiveness and safety of ^(125)I particles combining with chemotherapy and chemotherapy alone in the treatment of advanced pancreatic cancer.Methods The Chinese and foreign biomedical databases such as CNKI,China Biomedical Literature Database(CBM),Wanfang and Weipu Database,PubMed,Embase,Cochrane Library and so on were searched.The randomized controlled trials(RCT)of ^(125)I particles combining with chemotherapy and chemotherapy alone in the treatment of advanced pancreatic cancer were collected.The literature inclusion and exclusion criteria were established.The data from the selected literature were extracted after screening the literature.The data were analyzed using Stata 12.0 statistical software.Results A total of 10 studies were included,with a total of 582 patients.The objective response rate,pain relief rate,6-month survival rate,and 12-month survival rate of the ^(125)I particles implantation+chemotherapy group were significantly better than those of the chemotherapy alone group(P<0.05).There were no significant differences in the incidence of intestinal adverse reactions such as nausea and vomiting,the incidence of blood system adverse reactions such as white blood cell and platelet decline,and the incidence of liver function damage between the ^(125)I particles implantation+chemotherapy group and the chemotherapy alone group(P>0.05).But the incidence of pancreatic fistula,biliary fistula,abdominal infection,pancreatitis of the ^(125)I particles implantation+chemotherapy group was significantly higher than that of the chemotherapy alone group(P<0.05).Conclusion Both ^(125)I particles combining with chemotherapy and chemotherapy alone can effectively treat advanced pancreatic cancer.The combined regimen is more effective than chemotherapy alone,and has a low incidence of side effects.