摘要
目的 评价胃癌切除术后的不同药物、剂量、经静脉化疗方案的疗效和安全性。方法 计算机检索Medline和Embase(1980 - 2 0 0 1.4 ) ,检索词“chemotherapy ,stomachneoplasms ,surgery” ,并限制文章语言种类为English ;同时计算机检索中国生物医学文摘数据库 (1990 - 2 0 0 1.1) ,检索词“化疗 ,胃癌 ,手术”。对资料进行初筛 ,选取试验包括上述治疗组和对照组的文献 ,然后筛除明显不是随机临床试验的研究 ,对剩余的文献开始查找全文 ,进一步判断是否为RCT。纳入标准为 :(1)随机临床试验 (randomisedclinicaltrial,RCT)无论是否为单盲、双盲或非盲法 ;(2 )试验包含平行的对照组 ,即仅行胃癌根治性 /姑息性切除手术 (原发包块切除 ) ,术后不接受任何途径的化疗或仅接受安慰剂治疗 ;(3)治疗组为胃癌根治性 /姑息性切除术后接受不同药物、剂量的静脉化疗者 ;(4 )术前未接受化疗、放疗或其它肿瘤治疗。排除标准 :任何时间接受了放疗、免疫治疗、生物治疗者。应用国际Cochrane协作网的系统评价方法对全世界关于胃癌切除术后接受不同药物、剂量、经静脉化疗组与单纯手术组疗效的随机和半随机试验进行了系统评价。结果 共收集到 2 7篇关于胃癌切除术后接受不同药物、剂量、经静脉化疗组与单纯手术组疗效的随?
Objective To assess the safety and effect of different intravenous chemotherapic regimens in patients with gastric carcinomas who had received gastrectomy. Methods A systematic review of all the relevant randomized controlled trials(RCTs) was performed. RCTs were identified from Medline and Embase(1980-2001/4), Chinese Bio-medicine Database(1990-2001/1).Literature references were checked at the same time. We included randomized and quasi-randomized trials in patients with confirmed gastric carcinomas who had received gastrectomy comparing the effect of intravenous chemotherapy after gastrectomy with that of gastrectomy alone. Results Twenty trials involving 4?171 patients were included. Meta-analysis was done with fixed effects model. Heterogeneity analyses was performed also. The effects of intravenous chemotherapy with 5FU+MCCNU?5FU+MMC?5FU+BCNU or FAM after gastrectomy were failed to show have better effects than that of surgery alone. There were eleven trials which detailed the side effects according to the toxicity grade by WHO standard. The side effects halting treatment were haematologic and biochemical toxicity, debilitating nausea and vomiting. There were twenty-two patients died of chemotherapic toxicity. Conclusions Based on the review, there is no enough evidence to show that intravenous chemotherapy after gastrectomy have positive treatment effect on gastric cancer.
出处
《中国循证医学杂志》
CSCD
2003年第1期4-9,共6页
Chinese Journal of Evidence-based Medicine
基金
中国循证医学中心CMB子项目资助~~
关键词
胃癌
切除术后
化疗
治疗
系统评价
Stomach neoplasms
surgery/gastrectomy
chemotherapy/intravenous
systematic review
randomized clinical trials
Meta-analyses
