Objective To evaluate the efficacy and adverse effects of GP (gemcitabine+cisplatin) regimen and FP (fluouracil+cisplatin) regimen in treatment of advanced nasopharyngeal carcinoma by meta-analyses.Methods We search all relevant literature in network databases including PubMed,The Cochane Library,Embase,SCI,CBM,Medicine Ovid,CNKI and VIP.The original articles about clinical randomized controlled trials comparing the chemotherapy of GP and FP regimen in treatment of advanced nasopharyngeal carcinoma were recruited from the databases.The quality of the eligible trials was assessed by Jadad-scale method.RevMan5.3 software was used for meta-analyses.Results Forteen studies involving 1 253 patients were accorded with the inclusion criteria.The results of meta-analyses indicated that:in the aspect of efficacy,1-year-survival、3-year-survival and remission rates of GP were higher than FP regimen(RR=1.07,95%CI:1.01~1.13,P=0.03),(RR=1.20,95%CI:1.07~1.33,P=0.001),(RR=1.23,95%CI:1.09~1.40,P=0.000 9);in the aspect of adverse effects:the hematology toxicity was similar(P≥0.05);and the gastrointestinal reactions(nausea、vomiting)of GP regimen was relatively slighter(P<0.000 01).Conclusions GP regimen has better efficacy and slighter adverse effects compared with FP in treatment of advanced nasopharyngeal carcinoma.Maybe we can consider the GP regimen as a better choice,but we have to conform more high quality RCTS to confirm this conclusion.%目的 运用Meta分析的方法,比较吉西他滨联合顺铂(GP)方案和氟尿嘧啶联合顺铂(FP)方案治疗晚期鼻咽癌的疗效和不良反应.方法 计算机检索Pubmed、Cochrane Library、Embase、SCI、CBM、Medicine Ovid、CNKI、维普等数据库,同时辅助其它检索方式,纳入GP和FP方案比较治疗晚期鼻咽癌的临床随机对照试验,按照Jadad质量计分法对纳入的每篇文献进行方法学质量评估,使用RevMan5.3软件进行统计学分析.结果 纳入14篇文献,共1 253例晚期鼻咽癌病人,其中GP组607例,FP组646例.Meta分析结果显示:GP方案和FP方案相比,在疗效方面:1年生存率(RR=1.07,95%CI:1.01~1.13,P=0.03)、3年生存率(RR=1.20,95%CI:1.07~1.33,P=0.001)和客观缓解率(RR=1.23,95%CI:1.09~1.40,P=0.000 9)差异有统计学意义,且GP方案优于FP方案;在不良反应方面:血液学毒性差异无统计学意义(P≥0.05);消化道反应(恶心、呕吐)相对较低(P<0.000 01).结论 GP与FP方案相比,具有较好的疗效和更轻微的毒副作用,结合之前学者的临床试验结果,可考虑将GP方案作为晚期鼻咽癌的一线治疗方案.该结论有待于进一步加大样本量进行证实.
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