Ⅰ～Ⅲ期胰腺癌患者胰十二指肠切除术联合替吉奥辅助化疗临床疗效及安全性的Meta分析

【摘要】 目的 系统评价胰十二指肠切除术联合替吉奥辅助化疗对Ⅰ～Ⅲ期胰腺癌患者临床疗效及安全性。方法 全面检索国内外各大数据库,搜集关于胰十二指肠切除术联合替吉奥的治疗方案治疗中晚期胰腺癌的临床随机对照试验,由2位研究人员独立筛选文献、提取资料、评价偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果 共检索且纳入文献7篇,共878例Ⅰ-Ⅲ期胰腺癌患者,其中对照组436例,治疗组442例。本文文献质量评价根据改良Jadad评分方法所得,1篇为6分,1篇为5分,5篇为3分。Meta分析结果与对照组比较,胰十二指肠切除术联合替吉奥辅助化疗组可改善近期疗效(RR=1.37,95%CI [1.20,1.57],P<0.00001),可提高1年生存率和2年生存率(RR=1.19,95%CI[1.11,1.27],P<0.00001;RR=1.45,95%CI[1.28,1.65],P<0.00001)。联合组在不良反应发生率上与常规化疗组相当(RR=0.85,95%CI [0.65,1.10],P=0.21)。结论 胰十二指肠切除术联合替吉奥辅助化疗能改善Ⅰ～Ⅲ期胰腺癌患者近期临床疗效,提高1年和2年生存率,同时在安全性方面与常规化疗方案相当,无明显增加风险。更多还原

【Abstract】 Objective Meta-analysis of adverse events and clinical observation of pancreaticoduodenectomy combined with S-1 adjuvant chemotherapy for patients with Ⅰ-Ⅲ pancreatic cancer.Methods A comprehensive search was conducted on major domestic and foreign databases to collect clinical randomized controlled trials of pancreaticoduodenectomy combined with S-1 in the treatment of advanced pancreatic cancer.The literature was screened,the data were extracted,and the risk of bias was evaluated by two researchers independently.RevMan 5.3 software was used for metaanalysis.Results A total of 878 patients with stage Ⅰ-Ⅲ pancreatic cancer were included in 7 literatures,including 436 in the control group and 442 in the treatment group.According to the improved Jadad scoring method,the quality evaluation of this paper including 1 paper with 6 points,1 paper with 5 points,and 5 articles with 3 points.Results Of meta-analysis:compared with the control group,pancreaticoduodenectomy combined with S-1 adjuvant chemotherapy improved short-term efficacy(RR=1.37,955 CI [1.20,1.57 ],P<0.00001),improved 1-year survival rate and 2-year survival rate(RR=1.19,95% CI [1.11,1.27],P<0.00001.RR=1.45,95%,CI [1.28,1.65],P<0.00001),and the differences were statistically significant.The incidence of adverse reactions in the combined group was similar to that in the conventional chemotherapy group(RR=0.85,95%CI [0.65,1.10],P=0.21),with no significant difference between the groups.Conclusion Pancreaticoduodenectomy combined with S-1 adjuvant chemotherapy for patients with stage Ⅰ-Ⅲ pancreatic cancer can improve its recent clinical curative effect,raise survival rate of the 1 year and 2 years in security at the same time with conventional chemotherapy,no obvious increase risk.更多还原