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华西医学  2015 

卡培他滨联合伊立替康对比氟尿嘧啶联合伊立替康治疗晚期结直肠癌疗效与安全性的Meta分析

DOI: 10.7507/1002-0179.20150542, PP. 1891-1900

Keywords: 卡培他滨,伊立替康,氟尿嘧啶,转移性结直肠癌

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Abstract:

目的?评价卡培他滨联合伊立替康(CAPIRI)方案与氟尿嘧啶联合伊立替康(FOLFIRI)方案对照治疗晚期结直肠癌的疗效与安全性。方法?运用计算机在PubMed、Embase数据库、万方数据库、中国知网、Cochran图书馆上进行检索。检索时间均从2000年1月-2015年10月,对符合纳入标准的随机对照试验进行质量评价、数据提取并应用RevMan5.2进行Meta分析。结果?纳入8个随机对照试验,共计1634例患者,CAPIRI在完全缓解率RR=1.17,95%CI(0.70,1.96),P=0.56、总有效率RR=0.90,95%CI(0.79,1.03),P=0.12、疾病控制率RR=0.93,95%CI(0.87,1.00),P=0.06、中位无疾病进展期HR=1.00,95%CI(0.72,1.37),P=0.99、中位总生存期HR=0.94,95%CI(0.63,1.40),P=0.77方面表现出与FOLFIRI相似的效果。安全性方面,CAPIRI有较高的Ⅲ/Ⅳ级呕吐RR=1.91,95%CI(1.13,3.22),P=0.02、腹泻RR=2.84,95%CI(2.22,3.63),P<0.00001、手足综合征RR=4.55,95%CI(2.15,9.61),P<0.0001发生风险;而恶心RR=0.77,95%CI(0.64,0.93),P=0.005、疲劳RR=1.19,95%CI(0.73,1.94),P=0.47、发热性中性粒细胞减少RR=1.59,95%CI(0.89,2.87),P=0.12、贫血RR=1.74,95%CI(0.59,5.18),P=0.32、白细胞减少RR=1.23,95%CI(0.86,1.77),P=0.25、嗜中性粒细胞减少症RR=0.77,95%CI(0.64,0.93),P=0.005两组方案则相似。结论?CAPIRI治疗晚期结直肠癌是有效的,毒性反应是可以接受及处理的。

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