化疗期间体重减轻与晚期胃癌预后因素的Meta分析

Meta-analysis of weight loss and prognostic factors of advanced gastric cancer during chemotherapy

目的对已发表的队列研究进行Meta分析,了解化疗期间体重减轻是否是影响晚期胃癌预后的不良危险因素。方法本文通过检索PUBMED、Cochrane Library、EMBASE、CNKI、Wan Fang Data数据库,搜集相关队列研究文献。两名研究者独立筛选文献、提取数据,按照NOS量表评价文献,采用Revman5.1软件进行Meta分析,采用亚组分析法分析结果异质性。在本Meta分析中共纳入5项研究,涉及2468名患者。结果化疗期间体重减轻是影响晚期胃癌患者总生存期的危险因素[HR为0.72(95%CI:0.63~0.82,P<0.05,I^(2)=70.0%)];化疗期间体重减轻不是影响晚期胃癌患者无进展生存时间的危险因素[HR为0.91(95%CI:0.62~1.32,P>0.05,I^(2)=0.0%)];异质性分析结果:对晚期胃癌患者使用氟尿嘧啶类联合铂类引起的体重减轻是影响晚期胃癌患者总生存期的危险因素[HR为0.77(95%CI:0.65~0.90,P<0.05,I^(2)=83.0%)];引起体重减轻的Cut-off值不是导致本研究异质性较高的主要原因[HR为0.66(95%CI:0.57~0.76,P<0.05,I^(2)=0.0%)]。结论化疗期间体重减轻是影响晚期胃癌预后的不良危险因素。

Objective To conduct a meta-analysis of published cohort studies to determine whether weight loss is a risk factor for the prognosis of advanced gastric cancer during chemotherapy.Methods PUBMED,Cochrane Library, EMBASE,CNKI and Wanfang Data were searched to collect relevant literatures of cohort study.The two researchers screened the literatures and extracted data independently.The literatures were evaluated according to NOS scale.Software Revman 5.1 was used for meta-analysis, and subgroup analysis was used to analyze the heterogeneity of the results.Five studies involving 2 468 patients were included in this meta-analysis.Results Weight loss was a risk factor affecting the overall survival of patients with advanced gastric cancer during chemotherapy[HR:0.72(95% CI:0.63~0.82,P<0.05,I;=70.0%)].Weight loss was not a risk factor for progression-free survival of patients with advanced gastric cancer during chemotherapy[HR:0.91(95% CI:0.62~1.32,P>0.05,I;=0.0%)].The results of heterogeneity analysis showed that weight loss caused by fluorouracil combined with platinum of patients with advanced gastric cancer was a risk factor affecting the overall survival of the patients[HR:0.77(95% CI:0.65~0.90,P<0.05,I;=83.0%)].The Cut-off value which caused weight loss was not the main reason for the high heterogeneity of this study[HR:0.66(95% CI:0.57~0.76,P<0.05,I;=0.0%)].Conclusion Weight loss is a risk factor affecting the prognosis of advanced gastric cancer during chemotherapy.