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目的:通过Meta分析,探讨吉西他滨联合顺铂和吉西他滨单药化疗在治疗晚期胰腺癌的意义。方法:通过MEDLINE、EMBASE、ASCO论文集等数据库检索国内外已发表和未发表的相关文献。选择治疗组为吉西他滨联合顺铂化疗,对照组为吉西他滨单药化疗的晚期胰腺癌随机对照试验(randomizedcontrolledtrial,RCT)。由两位评价者分别按上述检索策略收集资料,按纳入标准入选,主要对总生存率进行Meta分析,其次是客观缓解率和毒副反应。结果:共纳入6个RCT。吉西他滨联合顺铂化疗与吉西他滨单药化疗比较,半年生存率无差别(P=0.24),临床获益反应率无差别(P=0.58),客观缓解率提高6%(P=0.05),半年TTP/TTF提高了9%(P=0.02);同时3/4度毒副反应可能会增加,中性粒细胞减少症增加6%(P=0.08)、血小板减少症增加8%(P=0.17)、恶心/呕吐增加11%(P=0.07),但均无统计学意义。结论:现有证据不推荐吉西他滨联合顺铂治疗晚期胰腺癌,吉西他滨单药化疗仍是目前的标准治疗。
Objective: To investigate the significance of gemcitabine combined with cisplatin and gemcitabine monotherapy in the treatment of advanced pancreatic cancer by Meta-analysis. Methods: The published and unpublished related literatures at home and abroad were searched through MEDLINE, EMBASE and ASCO Proceedings. The treatment group was gemcitabine combined with cisplatin and the control group was randomized controlled trial (RCT) of gemcitabine monotherapy. The two reviewers, respectively, according to the above search strategy to collect data, selected according to the inclusion criteria, the main analysis of the overall survival rate of Meta analysis, followed by the objective response rate and adverse reactions. Results: A total of 6 RCTs were included. There was no difference in half-year survival rate between gemcitabine and cisplatin plus gemcitabine chemotherapy (P = 0.24), no difference in clinical benefit (P = 0.58), objective response rate 6% (P = 0.05) / TTF increased by 9% (P = 0.02); third-degree toxicity was also likely to increase with neutropenia by 6% (P = 0.08) and thrombocytopenia by 8% (P = , Nausea / vomiting increased by 11% (P = 0.07), but no statistical significance. Conclusions: There is no evidence that gemcitabine plus cisplatin is recommended for advanced pancreatic cancer. Gemcitabine monotherapy remains the current standard of care.