替吉奥与卡培他滨治疗结直肠癌疗效与安全性的 Meta 分析

摘要

Objective:To systematically evaluate the efficacy and safety of tegafur gimeracil oteracil(S -1)and capecitabine for colorectal cancer.Methods:Computer -based retrieval was performed on PubMed,Cochrane Library, Embase,CNKI.Papers were selected according to the inclusion and exclusion criteria.After collecting the data and e-valuating the quality of included studies,RevMan 5.2 was used to perform Meta -analysis.Results:Five randomized controlled trials(RCTs)involving 867 patients were included.The results showed there was no significant difference between the efficacy of S -1 and capecitabine,and the CR[OR =0.60,95%CI(0.18,2.02),P =0.41],PR[OR =1.40,95%CI(0.96,2.04),P =0.08]and mPFS[OR =0.78,95%CI(0.43,1.42),P =0.41],mOS[OR =1.02, 95%CI(0.59,1.77),P =0.94]were not discrepant.For the patients receiving S -1 regimen,the incidence of hand foot syndrome was much lower during or after the treatment than those who received capecitabine regimen.The inci-dence of other adverse reactions including digestive syndrome,blood syndrome and nervous system syndrome was simi-lar between the two groups.Conclusion:As the present evidence shows,there is no significant difference between the efficacy of S -1 group and capecitabine group in the treatment of colorectal cancer.But patients receiving S -1 regi-men have lower probability to have hand foot syndrome,and there is no significant difference in other system toxici-ties.%目的：系统评价替吉奥与卡培他滨治疗结直肠癌的疗效与安全性。方法：计算机检索 PubMed、Co-chrane Library、Embase 与中国知网数据库关于比较替吉奥和卡培他滨治疗结直肠癌疗效性与安全性的随机对照试验。按照纳入与排除标准挑选文献，提取资料和评价纳入研究质量，并用 RevMan 5．2软件进行 Meta分析。结果：纳入5个临床 RCT，共867例患者。Meta 结果显示，替吉奥组和卡培他滨组完全缓解率 CR[OR＝0．60，95％CI（0．18，2．02），P ＝0．41]、部分缓解率 PR[OR ＝1．40，95％CI（0．96，2．04），P ＝0．08]差异无统计学意义。中位无进展生存时间 mPFS[OR ＝0．78，95％CI（0．43，1．42），P ＝0．41]和中位总生存时间 mOS [OR ＝1．02，95％CI（0．59，1．77），P ＝0．94]差异无统计学意义。两种化疗方案中，替吉奥组手足综合征发生率低于卡培他滨组，差异有统计学意义（P ＝0．03）。在消化系统、血液系统以及周围神经系统毒副反应差异性不明显。结论：替吉奥与卡培他滨治疗结直肠癌有效，两种药物治疗效果相当，但替吉奥组手足综合征发生率低于卡培他滨组，其余毒副反应差异不明显，其毒副反应均在可控范围内。