摘要
目的系统评价含奥沙利铂（OXA）的系统化疗方案治疗晚期原发性肝癌,主要是肝细胞癌（HCC）的有效性和安全性的前瞻性研究。方法检索Pub Med、Cochrane Library、EMBASE、Web of Science、中国期刊全文数据库、中国生物医学文献数据库以及万方数据库等文献数据库,检索时限均为建库至2015年4月。收集含OXA系统化疗方案治疗HCC的研究文献,进行文献质量评价后,采用Stata12.0软件对满足纳入标准的研究进行Meta分析。结果共纳入符合标准的文献12篇,合计600例患者。Meta分析结果显示,含OXA系统化疗方案对于晚期HCC患者具有一定的客观疗效,缓解率（RR）为14.0%（95%CI：9.5%~18.5%）,12项研究中患者的中位无进展生存期（PFS）和中位总生存期（OS）分别为4.7个月和9.5个月,1年无进展生存率和1年生存率分别为19.0%和35.6%。中、重度（3、4级）不良反应主要为中性粒细胞减少（16.6%）、血小板减少（8.7%）、贫血（5.4%）、神经毒性（4.9%）、恶心呕吐（1.8%）以及腹泻（2.9%）。进一步亚组分析表明,亚洲和西方患者的RR分别为13.9%（95%CI：8.1%~19.7%）和14.2%（95%CI：5.3%~23.1%）;亚洲患者群的中位PFS和中位OS分别为3.0个月和9.4个月,1年无进展生存率和1年生存率分别为12.9%和30.3%;而西方患者群依次为4.7个月、9.5个月、20.0%和42.4%。亚洲和西方患者群对含OXA系统化疗方案治疗晚期HCC的RR、1年无进展生存率和1年生存率之间均无显著差异（P〉0.05）。结论采用含OXA系统化疗方案治疗晚期HCC行之有效,安全性较好,不良反应可以耐受,建议作为临床上合理、可行的治疗选择。
Objective To systemically evaluate the efficacy and safety of oxaliplatin（ OXA）-based systemic chemotherapy regimens for advanced primary hepatic carcinoma,mainly hepatocellular carcinoma（ HCC）. Methods The original articles were searched from Pub Med,the Cochrane Library,EMBASE,Web of Science,CNKI,CBM and CECDB from inception to April 2015.Then we recruited the articles about OXA-based chemotherapy regimens for HCC,and evaluated the quality of literature. Finally we carried out a meta analysis of the eligible articles using Stata12. 0. Results Twelve study reports,including 600 patients were recruited in this study. The results of meta analysis showed that OXA-based chemotherapy regimens had certain curative effect on advanced HCC patients. The overall response rate（ RR） was 14. 0 %（ 95% CI： 9. 5%-18. 5%）. The median progression free survival（ PFS） /median overall survival（ OS） was 4. 7 /9. 5 months,with 1 year progression free survival rate /1 year survival rate were 19. 0% /35. 6%. The common moderate-severe（ grade 3 /4） toxicities were neutropenia（ 16. 6%）,thrombocytopenia（ 8. 7%）,anemia（ 5. 4%）,neurotoxicity（ 4. 9%）,nausea/vomiting（ 1. 8%） and diarrhea（ 2. 9%）. In the subgroup analysis,RR of Asian and Western patients were 13. 9%（ 95% CI： 8. 1%-19. 7%） and 14. 2%（ 95% CI： 5. 3%-23. 1%） respectively. In Asian studies,the median PFS / median OS and 1 year progression free survival rate /1 year survival rate were 3. 0 /9. 4 months and 12. 9% /30. 3% respectively.In Western studies,median PFS / OS and 1 year progression free survival rate /1 year survival rate were 4. 7 months /9. 5 months and20. 0% /42. 4% respectively. RR,1 year progression free survival rate and 1 year survival rate of OXA-based systemic chemotherapy regimens for advanced HCC had no significant difference（ P 0. 05） between Asian and Western patients. Conclusion OXA-based systemic chemotherapy regimens are effective and safe for advanced HCC. It indicates that OXA-based syst
出处
《临床肿瘤学杂志》
CAS
2015年第9期769-779,共11页
Chinese Clinical Oncology
基金
江苏省科技厅科技支撑计划资助项目(BE2012766)
南京军区医学研究重点课题资助项目(09Z012
11Z014)
