白蛋白结合型紫杉醇联合吉西他滨治疗进展期胰腺癌临床效果的Meta分析

王芸; 张耕源; 罗长江; 杨含腾

doi:10.3969/j.issn.1001-5256.2019.05.021

白蛋白结合型紫杉醇联合吉西他滨治疗进展期胰腺癌临床效果的Meta分析

DOI: 10.3969/j.issn.1001-5256.2019.05.021

1. 甘肃省武威肿瘤医院化疗科
2. 兰州大学第二医院普通外科

基金项目:

甘肃省卫生厅行业计划项目(GZK-2016-33)；

详细信息

中图分类号: R735.9
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出版历程
- 收稿日期: 2019-03-06
- 出版日期: 2019-05-20

Clinical effect of nanoparticle albumin-bound paclitaxel combined with gemcitabine in treatment of advanced pancreatic cancer: A meta-analysis

Department of Chemotherapy, Wuwei Cancer Hospital of Gansu Province

Research funding:

摘要

摘要: 目的系统分析白蛋白结合型紫杉醇联合吉西他滨化疗方案在治疗进展期胰腺癌方面的临床效果,为临床决策更好的制订提供依据。方法以英文检索词:pancreatic cancer,gemcitabine,nab-paclitaxel and abraxane和中文检索词:胰腺癌、吉西他滨及白蛋白结合型紫杉醇等对中国生物医学文献数据库、中国知网、万方数据资源库、维普数据库、PubMed、Embase、Cochrane Library、Web of Science等数据库进行检索,检索出从建库至2018年10月的中英文文献。依据文献纳入与排除标准,筛选出合适的临床研究文献,提取数据并行文献质量评价,应用RevMan5. 3统计软件进行分析。结果共纳入10篇临床研究文献,总计2908例患者,其中试验组（白蛋白结合型紫杉醇联合吉西他滨） 1633例,对照组（FOLFIRINOX） 1275例。Meta分析结果显示,试验组药物毒副作用发生率,如疲乏[比值比（OR）=0. 61,95%可信区间（95%CI）=0. 46～0. 80,P=0. 0005]、腹泻（OR=0. 39,95%CI:0. 29～0. 5...
- 胰腺肿瘤 /
- 白蛋白结合型紫杉醇 /
- 抗肿瘤联合化疗方案 /
- Meta分析
Abstract: Objective To investigate the clinical effect of nanoparticle albumin-bound paclitaxel ( nab-paclitaxel) combined with gemcitabine in the treatment of advanced pancreatic cancer, and to provide a basis for making better clinical decisions. Methods CBM, CNKI, Wanfang Data, VIP, PubMed, Embase, Cochrane Library, and Web of Science were searched for Chinese and English articles published up to October 2018, with English keywords of“pancreatic cancer”, “gemcitabine”, “nab-paclitaxel”, and “abraxane”and Chinese keywords of“pancreatic cancer”, “gemcitabine”, and“nanoparticle albumin-bound paclitaxel” ( in Chinese) . Appropriate clinical trials were screened out according to the inclusion and exclusion criteria. Then, the data were extracted and quality assessment was performed. RevMan 5. 3 software was used to perform the meta-analysis. Results A total of 10 clinical trials were included, with a total of2908 patients. There were 1633 patients in the study group ( treated with nab-paclitaxel combined with gemcitabine) and 1275 patients in the control group ( treated with FOLFIRINOX) . The results of the meta-analysis showed that compared with the control group, the study group had significantly lower incidence rates of drug side-effects such as fatigue ( odds ratio [OR]= 0. 61, 95% confidence interval [CI]:0. 46-0. 80, P = 0. 0005) , diarrhea ( OR = 0. 39, 95% CI: 0. 29-0. 54, P < 0. 001) , nausea and vomiting ( OR = 0. 46, 95% CI: 0. 26-0. 84, P = 0. 01) , and grade 3-4 neutropenia ( OR = 0. 61, 95% CI: 0. 43-0. 88, P = 0. 007) , as well as a significantly lower rate of second-line treatment ( OR = 0. 30, 95% CI: 0. 14-0. 63, P = 0. 001) . There were no significant differences between the two groups in disease remission rate ( OR = 0. 82, 95% CI: 0. 45-1. 51, P = 0. 53) , disease control rate ( OR = 0. 97, 95% CI: 0. 48-1. 97, P =0. 93) , 1-year survival rate ( OR = 0. 80, 95% CI: 0. 63-1. 01, P = 0. 06) , and incidence rate of complications after neoadjuvant chemotherapy ( OR = 1. 84, 95% CI: 0. 33-10. 19, P = 0. 49) . Conclusion Nab-paclitaxel combined with gemcitabine can improve the clinical outcome of advanced pancreatic cancer without increasing drug adverse events, and therefore, it has good safety and efficacy in clinical practice.
- pancreatic neoplasms /
- albumin-bound paclitaxel /
- antineoplastic combined chemotherapy protocols /
- Meta-analysis

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参考文献(16)

[1] BRAY F, FERLAY J, SOERJOMATARAM I, et al. Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68 (6) :394-424.

[2] CHEN WQ, SUN KX, ZHENG RS, et al. Report of cancer incidence and mortality in different areas of China, 2014[J]. China Cancer, 2018, 27 (1) :1-14. (in Chinese) 陈万青, 孙可欣, 郑荣寿, 等. 2014年中国分地区恶性肿瘤发病和死亡分析[J].中国肿瘤, 2018, 27 (1) :1-14.

[3] FRAMPAS E, DAVID A, REGENET N, et al. Pancreatic carcinoma:Key-points from diagnosis to treatment[J]. Diagn Interv Imaging, 2016, 97 (12) :1207-1223.

[4] YANG YM, LI JS. Current status and progress of comprehensive treatment for locally advanced pancreatic cancer[J].Chin J Dig Surg, 2017, 16 (10) :979-982. (in Chinese) 杨尹默, 李佶松.局部进展期胰腺癌综合治疗的现状与进展[J].中华消化外科杂志, 2017, 16 (10) :979-982.

[5] de LUCA R, BLASI L, ALU M, et al. Clinical efficacy of nabpaclitaxel in patients with metastatic pancreatic cancer[J].Drug Des Devel Ther, 2018, 12:1769-1775.

[6] TAHARA J, SHIMIZU K, OTSUKA N, et al. Gemcitabine plus nab-paclitaxel vs. FOLFIRINOX for patients with advanced pancreatic cancer[J]. Cancer Chemother Pharmacol, 2018, 82 (2) :245-250.

[7] KANG J, HWANG I, YOO C, et al. Nab-paclitaxel plus gemcitabine versus FOLFIRINOX as the first-line chemotherapy for patients with metastatic pancreatic cancer:Retrospective analysis[J]. Invest New Drugs, 2018, 36 (4) :732-741.

[8] CARTWRIGHT TH, PARISI M, ESPIRITO JL, et al. Clinical outcomes with first-line chemotherapy in a large retrospective study of patients with metastatic pancreatic cancer treated in a US community oncology setting[J]. Drugs Real World Outcomes, 2018, 5 (3) :149-159.

[9] KIM S, SIGNOROVITCH JE, YANG H, et al. Comparative effectiveness of nab-paclitaxel plus gemcitabine vs FOLFIRINOX in metastatic pancreatic cancer:A retrospective nationwide chart review in the United States[J]. Adv Ther, 2018, 35 (10) :1564-1577.

[10] MURANAKA T, KUWATANI M, KOMATSU Y, et al. Comparison of efficacy and toxicity of FOLFIRINOX and gemcitabine with nab-paclitaxel in unresectable pancreatic cancer[J]. J Gastrointest Oncol, 2017, 8 (3) :566-571.

[11] WANG Y, CAMATEROS P, CHEUNG WY. A real-world comparison of FOLFIRINOX, gemcitabine plus nab-paclitaxel, and gemcitabine in advanced pancreatic cancers[J]. J Gastrointest Cancer, 2019, 50 (1) :62-68.

[12] BRAITEH F, PATEL MB, PARISI M, et al. Comparative effectiveness and resource utilization of nab-paclitaxel plus gemcitabine vs FOLFIRINOX or gemcitabine for the first-line treatment of metastatic pancreatic adenocarcinoma in a US community setting[J]. Cancer Manag Res, 2017, 9:141-148.

[13] CHAPMAN BC, GLEISNER A, RIGG D, et al. Perioperative and Survival outcomes following neoadjuvant FOLFIRINOX versus gemcitabine abraxane in patients with pancreatic adenocarcinoma[J]. Med Oncol, 2018, 19 (2) :75-85.

[14] DHIR M, ZENATI MS, HAMAD A, et al. FOLFIRINOX versus gemcitabine/nab-paclitaxel for neoadjuvant treatment of resectable and borderline resectable pancreatic head adenocarcinoma[J]. Ann Surg Oncol, 2018, 25 (7) :1896-1903.

[15] HEGEWISCH-BECKER S, ALDAOUD A, WOLF T, et al. Results from the prospective German TPK clinical cohort study:Treatment algorithms and survival of 1, 174 patients with locally advanced, inoperable or metastatic pancreatic ductal adenocarcinoma[J]. Int J Cancer, 2019, 144 (5) :981-990.

[16] von HOFF DD, ERVIN T, ARENA FP, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine[J]. N Engl J Med, 2013, 369 (18) :1691-1703.

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