Meta-analysis of inoperable pancreatic cancer: gemcitabine combined with cisplatin versus gemcitabine alone.

De Rong Xie, Han Lin Liang, Yu Wang, Shuang Shuang Guo
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引用次数: 21

Abstract

Objectives: To compare the therapeutic effects of gemcitabine (GEM) monotherapy with GEM-cisplatin (DDP) combination chemotherapy in patients with advanced stage pancreatic cancer (APCa) through meta-analysis.

Methods: MEDLINE and EMBASE searches were supplemented by information from trial registers of randomized controlled trials (RCTs) for GEM-DDP combination chemotherapy and GEM alone in APCa. A quantitative meta-analysis using updated information based on inclusion criteria from all available RCTs was carried out by two reviewers. The primary meta-analysis involved the overall survival (OS), objective remission rate (ORR) and toxicity.

Results: The meta-analysis included six RCTs. There was no significant advantage for the GEM-DDP combination group in 6-month survival rate (P = 0.24) or clinical benefit rate (P = 0.58). There was a marginal significant improvement for the GEM-DDP combination group in ORR (RD = 6%, P = 0.05; RD, risk difference = risk in the GEM-DDP combination group - risk in the GEM alone group). Moreover, there was a significant improvement for the combination group in 6-month TTP/TTF (RD = 9%, P = 0.02). WHO grade 3-4 toxicity was higher for the GEM-DDP combination group in terms of neutropenia (RD = 6%, P = 0.08), thrombocytopenia (RD = 8%, P = 0.17) and vomiting/nausea (RD = 11%, P = 0.07); none reached significant difference.

Conclusion: GEM-DDP combination should not be recommended and GEM monotherapy remains the standard treatment for patients with APCa.

不能手术的胰腺癌荟萃分析:吉西他滨联合顺铂与单独吉西他滨。
目的:通过meta分析比较吉西他滨(GEM)单药治疗与GEM-顺铂(DDP)联合化疗治疗晚期胰腺癌(APCa)的疗效。方法:MEDLINE和EMBASE检索补充了GEM- ddp联合化疗和GEM单独治疗APCa的随机对照试验(rct)的试验注册信息。使用基于所有可用rct纳入标准的最新信息进行定量荟萃分析,由两名评论者进行。主要荟萃分析包括总生存期(OS)、客观缓解率(ORR)和毒性。结果:meta分析包括6项随机对照试验。GEM-DDP联合治疗组在6个月生存率(P = 0.24)和临床获益率(P = 0.58)方面无显著优势。GEM-DDP联合用药组的ORR有显著改善(RD = 6%, P = 0.05;RD,风险差异= GEM- ddp联合组风险- GEM单独组风险)。此外,联合治疗组在6个月TTP/TTF方面有显著改善(RD = 9%, P = 0.02)。GEM-DDP联合组在中性粒细胞减少(RD = 6%, P = 0.08)、血小板减少(RD = 8%, P = 0.17)和呕吐/恶心(RD = 11%, P = 0.07)方面的WHO 3-4级毒性更高;没有达到显著差异。结论:不推荐GEM- ddp联合治疗,GEM单药治疗仍是APCa患者的标准治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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