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目的评价XELOX方案和FOLFOX方案治疗晚期结直肠癌的临床疗效和不良反应。方法计算机检索万方数据库、维普数据库、CNKI数据库和PubMed数据库上公开发表的XELOX方案和FOLFOX方案治疗大肠癌的随机对照试验,并进行筛选,提取实验设计、研究对象特征、干预措施和研究结果,采用ReMan 5.3软件进行统计分析。结果共纳入18篇合格文献,Meta分析结果提示XELOX组有效率为43.50%(311/715),与FOLFOX组有效率47.37%(351/741)比较,两组总有效率差异无统计学意义[OR=0.87,95%CI(0.71,1.07),P=0.19]。白细胞减少两组比较差异有统计学意义[OR=0.41,95%CI(0.29,0.58),P<0.001]。两组恶心和呕吐情况比较差异无统计学意义[OR=0.86,95%CI(0.74,1.01),P=0.07]。两组腹泻比较差异无统计学意义[OR=1.05,95%CI(0.82,1.35),P=0.68]。两组口腔黏膜炎比较差异无统计学意义[OR=0.84,95%CI(0.52,1.34),P=0.01]。两组神经毒性比较差异有统计学意义[OR=0.89,95%CI(0.85,0.93),P<0.00001]。两组手足综合征比较差异有统计学意义[OR=3.77,95%CI(2.29,6.21),P<0.001]。结论 XELOX方案治疗晚期结直肠癌的疗效和FOLFOX方案近期疗效相当,在白细胞减少和神经毒性上XELOX组较FOLFOX组低,在手足综合征上XELOX组较高,在经济学指标上有一定优势。
Objective To evaluate the clinical efficacy and adverse reactions of XELOX regimen and FOLFOX regimen in the treatment of advanced colorectal cancer. Methods Randomized controlled trials of XELOX and FOLFOX on colorectal cancer published by Wanfang database, VIP database, CNKI database and PubMed database were searched and screened, and the experimental design, research object characteristics, interventions and research results were extracted. ReMan 5.3 software for statistical analysis. Results A total of 18 qualified articles were included in the study. The results of Meta analysis showed that the effective rate was 43.50% (311/715) in the XELOX group and no significant difference between the two groups in the total effective rate of 47.37% (351/741) in the FOLFOX group [ OR = 0.87, 95% CI (0.71, 1.07), P = 0.19]. Leukopenia was statistically significant difference between the two groups [OR = 0.41, 95% CI (0.29,0.58), P <0.001]. There was no significant difference in nausea and vomiting between the two groups [OR = 0.86, 95% CI (0.74, 1.01), P = 0.07]. There was no significant difference between the two groups of diarrhea [OR = 1.05,95% CI (0.82,1.35), P = 0.68]. There was no significant difference in oral mucositis between two groups [OR = 0.84, 95% CI (0.52, 1.34), P = 0.01]. There was significant difference in neurotoxicity between the two groups [OR = 0.89, 95% CI (0.85, 0.93), P <0.00001]. There was significant difference between the two groups in hand-foot syndrome [OR = 3.77, 95% CI (2.29, 6.21), P <0.001]. Conclusion The efficacy of XELOX regimen in the treatment of advanced colorectal cancer is comparable to that of FOLFOX regimen in the short term. XELOX group is lower than FOLFOX group in leukopenia and neurotoxicity, and XELOX group is higher in hand-foot syndrome, which has some advantages in economics.