吉西他滨联合高能聚焦超声治疗晚期胰腺癌效果的Meta分析

资力; 陈凯; 刘广林; 李仁礼; 许威

doi:10.3969/j.issn.1001-5256.2020.01.034

吉西他滨联合高能聚焦超声治疗晚期胰腺癌效果的Meta分析

DOI: 10.3969/j.issn.1001-5256.2020.01.034

1. 武警特色医学中心消化疾病研究所
2. 武警后勤学院
3. 天津市肝脏胰腺纤维化与分子诊疗重点实验室

基金项目:

天津市自然科学基金(17JCYBJC26700)；天津市科技计划项目(课题)(15ZXLCSY00040)；

详细信息

中图分类号: R735.9
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出版历程
- 收稿日期: 2019-07-12
- 出版日期: 2020-01-20

Clinical effect of gemcitabine combined with high-intensity focused ultrasound in treatment of advanced pancreatic cancer: A Meta-analysis

Institute of Digestive Diseases,Characteristic Medical Ceter of Chinese People's Armed Police

Research funding:

摘要

摘要: 目的评价吉西他滨(Gem)联合高能聚焦超声(HIFU)治疗晚期胰腺癌的安全性和有效性。方法网上检索SCI、Cochrane数据库、Embase、Pubmed、万方数据、中国知网、CBM、VIP文献库,再辅助以扩展检索,将检索到的HIFU联合Gem治疗晚期胰腺癌的随机对照试验按照纳入标准筛选。采用Review Manager5. 3进行Meta评价。非异质性数据使用固定效应模型;异质性按照干预方法进行亚组分析来解释异质性;如果仍然不能用亚组分析来解释,则采用随机效应模型。使用相对危险度(RR)及其95%可信区间(95%CI)作为评估指标,选取纳入研究数目多的结果绘制漏斗图。结果共纳入8篇随机对照试验(474例患者),试验组与对照组都接受Gem为基础的化疗,试验组加用HIFU治疗。试验组与对照组3、6、12个月的生存率RR值分别为1. 07(95%CI:1. 00～1. 14)、2. 19(95%CI:1. 75～2. 75)和2. 35(95%CI:1. 07～5. 14)(P值均<0. 05);肿瘤控制效果RR为1. 64(95%CI:1. 21～2. 24)(P=0. 002)...
- 胰腺肿瘤 /
- 高强聚焦超声消融 /
- 吉西他滨 /
- Meta分析(主题)
Abstract: Objective To evaluate the clinical effect and safety of high-intensity focused ultrasound(HIFU) combined with gemcitabine in the treatment of advanced pancreatic cancer. Methods SCI,Cochrane Library,Embase,PubMed,Wanfang Data,CNKI,CBM,and VIP were searched for randomized controlled trials(RCTs) of HIFU combined with gemcitabine in the treatment of advanced pancreatic cancer,with the assistance of expanded search,and these RCTs were screened according to the inclusion criteria. Review Manager 5. 3 was used to perform the Meta-analysis. A fixed effects model was used for non-heterogeneous data; heterogeneity was explained by subgroup analysis based on intervention methods,and if it could not be explained by subgroup analysis,a random effects model was used. Relative risk(RR) and 95% confidence interval(CI) were used as evaluation indices,and funnel plots were generated based on the outcome measure involved in the highest number of studies. Results A total of 8 RCTs with 474 patients were included. The patients in the experimental group received gemcitabine-based chemotherapy and HIFU,and those in the control group received gemcitabine-based chemotherapy alone. Compared with the control group,the experimental group had significantly better results in 3-,6-,and 12-month survival rates(3-month: RR = 1. 07,95% CI: 1. 00-1. 14,P < 0. 05; 6-month: RR = 2. 19,95% CI: 1. 75-2. 75,P < 0. 05; 12-month: RR =2. 35,95% CI: 1. 07-5. 14,P < 0. 05),tumor control(RR = 1. 64,95% CI: 1. 21-2. 24,P = 0. 002),and pain control(RR = 3. 15,95% CI: 2. 45-4. 05,P < 0. 05). There were no significant differences between the two groups in the incidence rates of leukopenia(RR =1. 05,95% CI: 0. 85-1. 30,P > 0. 05),gastrointestinal reactions(RR = 0. 89,95% CI: 0. 56-1. 42,P > 0. 05),and liver injury(RR = 1. 29,95% CI: 0. 95-1. 75,P > 0. 05). Since the outcome measure of pain control was involved in the highest number of studies,funnel plots were generated and showed no significant risk of bias. Conclusion Compared with gemcitabine alone,HIFU combined with gemcitabine can increase patients' survival rate and improve their symptoms,with a similar incidence rate of adverse effects. Further studies are needed for this combined therapy.
- pancreatic neoplasms /
- high-intensity focused ultrasound ablation /
- gemcitabine /
- Meta-analysis as topic

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参考文献(23)

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