奈达铂对比顺铂联合氟尿嘧啶治疗食管癌疗效和安全性的系统评价与Meta分析

Efficacy and safety of nedaplatin versus cisplatin plus fluorouracil for treatment of esophageal neoplasms:A systematic review and meta-analysis

目的系统评价奈达铂对比顺铂联合氟尿嘧啶治疗食管癌的疗效和安全性。方法计算机检索PubMed、EMbase、Web of Science、The Cochrane Library、中国知网、万方、维普和中国生物医学文献数据库,搜集关于奈达铂联合氟尿嘧啶对比顺铂联合氟尿嘧啶治疗食管癌的随机对照研究,检索时限均为建库至2021年1月。采用RevMan 5.4软件进行Meta分析。结果最终纳入12个随机对照研究,共含744例患者。Meta分析结果显示,奈达铂组的总有效率优于顺铂组(P<0.05);在毒副作用方面,奈达铂组恶心呕吐、腹泻、肾功能损伤发生率比顺铂组低(P<0.05),但白细胞减少、血红蛋白降低发生率较顺铂组高(P<0.05)。两组肝功能损伤和血小板减少发生率差异无统计学意义(P>0.05)。结论奈达铂联合氟尿嘧啶比顺铂联合氟尿嘧啶治疗食管癌更有优势,并且恶心呕吐以及腹泻的发生率更低,对肾功能的损害也更小。

Objective To systematically evaluate the efficacy and safety of nedaplatin versus cisplatin combined with fluorouracil in the treatment of esophageal neoplasms.Methods PubMed,EMbase,Web of Science,The Cochrane Library,CNKI,WanFang,VIP and CBM databases were searched by computer to investigate the randomized controlled studies about the clinical effects of nedaplatin combined with fluorouracil versus cisplatin combined with fluorouracil in the treatment of esophageal neoplasms.The retrieval time was from the establishment of the database to January 2021.And meta-analysis was performed using RevMan 5.4.Results A total of 12 randomized controlled studies involving 744patients were included.The results of meta-analysis showed that the total effective rate of the nedaplatin group was better than that of the cisplatin group(P<0.05).The incidence of nausea,vomiting,diarrhea and renal impairment in the nedaplatin group was lower than that in the cisplatin group(P<0.05),but the incidence of leukopenia and hemoglobin decline was higher than that in the cisplatin group(P<0.05).There was no statistical difference in the incidence of liver injury,or platelet decline between the two groups(P>0.05).Conclusion Nedaplatin combined with fluorouracil has more advantages than cisplatin combined with fluorouracil in the treatment of esophageal cancer,the incidence of nausea,vomiting and diarrhea is lower,and the damage to kidney function is also smaller.