化疗联合热疗治疗中晚期胰腺癌疗效Meta分析

Meta analysis of the efficacy of chemotherapy combined with hyperthermia in the treatment of advanced pancreatic cancer

目的系统评价化疗联合热疗治疗中晚期胰腺癌(PC)的疗效及安全性。方法检索外文数据库(Pubmed、EMBase、Cochrane Library)和中文数据库[中国知网(CNKI)、维普期刊(VIP)、万方数据库(Wan Fang)、中国生物医学文献数据库(CBM)],搜集化疗联合热疗与单纯化疗治疗中晚期胰腺癌的随机对照实验,检索时限自建库到2021年11月,文献语种不限,由两名研究者提取纳入文献数据,运用RevMan 5.3对结局指标进行数据分析。结果本篇研究共纳入8篇文献的随机对照实验(RCT),共535例患者,试验组274例,对照组261例。对纳入数据进行Meta分析显示,试验组治疗中晚期胰腺癌的客观缓解率[OR=3.33,95%CI(2.28,4.86),P<0.01]和临床受益率[OR=2.65,95%CI(1.20,5.82),P<0.05]与对照组比较,差异均有统计学意义;1年生存率比较差异无统计学意义[OR=1.51,95%CI(0.91,2.50),P=0.11];在Ⅲ~Ⅳ度骨髓抑制发生率方面,试验组白细胞毒性[OR=0.85,95%CI(0.44,1.63),P=0.62]和血小板毒性[OR=1.14,95%CI(0.56,2.35),P=0.71]与对照组比较,差异无统计学意义。结论在治疗中晚期胰腺癌方面,化疗联合热疗与单纯化疗相比,可以增加患者的近期疗效,提高生活质量,而在1年生存率和骨髓抑制方面差异无统计学意义。

ObjectiveEvidence-based medicine system to evaluate the efficacy and safety of chemotherapy combined with hyperthermia in the treatment of advanced pancreatic cancer.MethodsForeign databases(PubMed,EMBase,Cochrane Library)and Chinese databases(Chinese Biomedical literature Database,CNKI,VIP Journal,Wanfang Database)were searched to collect randomized controlled trials of chemotherapy combined with hyperthermia and chemotherapy alone in the treatment of intermediate and advanced pancreatic cancer.The retrieval time limit of the self-built database is November 2021,and there is no restriction on the language of literature.Two researchers extract the included literature data and use RevMan 5.3 for data analysis of outcome indicators.ResultsRCTS from 8 literatures were included in this study,including 535 patients,274 in the experimental group and 261 in the control group.Meta-analysis of included data showed that the objective remission rate[OR=3.33,95%CI(2.28,4.86),P<0.01]and clinical benefit rate[OR=2.65,95%CI(1.20,5.82),P<0.05]of the experimental group were statistically significant compared with the control group.There was no significant difference in one-year survival rate[OR=1.51,95%CI(0.91,2.50),P=0.11].There was no statistical significance in the incidence of gradeⅢtoⅣmyelosuppression in the experimental group leukocyte toxicity[OR=0.85,95%CI(0.44,1.63),P=0.62]and platelet toxicity[OR=1.14,95%CI(0.56,2.35),P=0.71]compared with the control group.ConclusionChemotherapy combined with hyperthermia increased short-term efficacy and quality of life in patients with advanced pancreatic cancer compared with chemotherapy alone,but there was no significant difference in one-year survival or bone marrow suppression.