S-1 联合治疗与 S-1 单药治疗晚期胃癌的疗效比较：一项荟萃分析。
S-1-based combination therapy vs S-1 monotherapy in advanced gastric cancer: a meta-analysis.
机构信息
Guo-Fang Liu, Su Wang, Ai-Hua Long, Nian-Lan Zhou, Li-Li Zhang, Xiao-Xing Xiang, Department of Gastroenterology and Hepatology, Subei People's Hospital of Jiangsu Province (Clinical Medical College of Yangzhou University), Yangzhou 225000, Jiangsu Province, China.
出版信息
World J Gastroenterol. 2014 Jan 7;20(1):310-8. doi: 10.3748/wjg.v20.i1.310.
AIM
To assess the efficacy and safety of combination therapy based on S-1, a novel oral fluoropyrimidine, vs S-1 monotherapy in advanced gastric cancer (AGC).
METHODS
We searched PubMed, EMBASE and the Cochrane Library for eligible studies published before March 2013. Our analysis identified four randomized controlled trials involving 790 participants with AGC. The outcome measures were overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and grade 3-4 adverse events.
RESULTS
Meta-analysis showed that S-1-based combination therapy significantly improved OS (HR = 0.77, 95%CI: 0.66-0.91, P = 0.002), PFS (HR = 0.58, 95%CI: 0.46-0.72, P = 0.000) and ORR (OR = 2.23, 95%CI: 1.54-3.21, P = 0.000). Sensitivity analysis further confirmed this association. Lower incidence of grade 3-4 leucopenia (OR = 4.06, 95%CI: 2.11-7.81), neutropenia (OR = 3.94, 95%CI: 2.1-7.81) and diarrhea (OR = 2.41, 95%CI: 1.31-4.44) was observed in patients with S-1 monotherapy.
CONCLUSION
S-1-based combination therapy is superior to S-1 monotherapy in terms of OS, PFS and ORR. S-1 monotherapy is associated with less toxicity.
目的
评估新型口服氟嘧啶 S-1 联合疗法对比 S-1 单药治疗晚期胃癌（AGC）的疗效和安全性。
方法
我们检索了 PubMed、EMBASE 和 Cochrane Library 中截至 2013 年 3 月前发表的合格研究。我们的分析确定了四项涉及 790 例 AGC 患者的随机对照试验。结局指标为总生存期（OS）、无进展生存期（PFS）、总缓解率（ORR）和 3-4 级不良事件。
结果
荟萃分析显示，S-1 联合疗法显著改善了 OS（HR=0.77，95%CI：0.66-0.91，P=0.002）、PFS（HR=0.58，95%CI：0.46-0.72，P=0.000）和 ORR（OR=2.23，95%CI：1.54-3.21，P=0.000）。敏感性分析进一步证实了这种关联。S-1 单药治疗组白细胞减少症（OR=4.06，95%CI：2.11-7.81）、中性粒细胞减少症（OR=3.94，95%CI：2.1-7.81）和腹泻（OR=2.41，95%CI：1.31-4.44）的发生率较低。
结论
S-1 联合疗法在 OS、PFS 和 ORR 方面优于 S-1 单药治疗。S-1 单药治疗毒性较低。
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