摘要
目的评价10-羟基喜树碱治疗胃肠道肿瘤的近期临床疗效和安全性.方法电子检索中国学术期刊网全文数据库（1995～2005）,MEDLINE（1995～2005）和Cochrane图书馆（2005第1期）,并与研究者联系以获得更多相关研究资料.纳入比较10-羟基喜树碱（10-HCPT）或以10-HCPT为主的二联及多联化疗方案治疗胃肠道肿瘤的随机对照试验,比较两组化疗有效率、消化道和血液毒性反应率.由两名评价员独立检索和提取资料并交叉核对,对纳入文献的方法学质量进行评价,数据采用RevMan4.2.2版软件进行统计分析.结果共纳入25个试验,共1 881例患者.Meta分析结果提示：10-HCPT可以显著提高近期大肠癌化疗疗效[OR 1.62,95%CI（1.37,1.92）]和胃癌化疗疗效[OR 1.48,95%CI（1.18,1.85）],其所致消化道严重毒性反应发生率与对照组比较差异无统计学意义[OR 0.96,95%CI（0.62,1.50）],但血液系统严重毒性反应发生率却显著增高[OR 1.27,95%CI（1.02,1.58）].结论现有研究资料显示,10-HCPT可以提高胃肠道肿瘤化疗近期临床疗效,但会增加血液系统严重毒性反应发生率,其在改善预后方面的作用还需要进一步研究.
Objective To evaluate the short-term clinical efficacy and safety of 10-Hydroxy-camptothecin （10- HCPT ） chemotherapy on gastrointestinal carcinoma. Methods We searched electronic database including CNKI （ 1995 - 2005 ）, MEDLINE （ 1995 - 2005 ） and The Cochrane Library （ Issue 1, 2005 ）. More related research data were odtained by cantacting with researchers. Randomized controlled trials of gastrointestinal carcinoma chemotherapy comparing only or including 10-HCPT chemotherapy with normal chemotherapy on efficacy rate, digestive and hematology system toxicity were included. Data related to the clinical outcome were extracted by two reviewers independently. Statistical analysis was performed by using RevMan4. 2.2. Results Twenty-five trials including 1 881 patients met the inclusion criteria. The results of meta-analysis were hsted as follows： 10-HCPT could significantly improve the short-term chemotherapy efficacy for colorectal cancer （ RR. 1.62, 95% CI 1.37 to 1.92） and gastric cancer （RR 1.48, 95% CI 1.18 to 1.85）in chemotherapy curative efficacy in short-term. 10-HCPT induced severe toxicity of lower digestive system（RR. 0.96,95% CI 0.62 to 1.50 ） without statistical significance, while severe toxicity of hematology system was significantly higher than that of control with RR 1.27,95% CI 1.02 to 1.58. Conclusions Current evidence suggests that 10-HCPT can improve hematology system short-term chemotherapy efficacy for gastrointestinal carcinoma and increase the incidence of severe toxicity. Further research is needed to value its influence on the prognosis of gastrointestinal carcinoma.
出处
《中国循证医学杂志》
CSCD
2006年第2期124-130,共7页
Chinese Journal of Evidence-based Medicine
