在局部晚期直肠癌的标准新辅助放化疗中添加奥沙利铂的临床获益：一项荟萃分析：奥沙利铂在直肠癌新辅助治疗中的应用
Clinical benefit of adding oxaliplatin to standard neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a meta-analysis : Oxaliplatin in neoadjuvant treatment for rectal cancer.
作者信息
De Felice Francesca, Benevento Ilaria, Magnante Anna Lisa, Musio Daniela, Bulzonetti Nadia, Caiazzo Rossella, Tombolini Vincenzo
机构信息
Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
出版信息
BMC Cancer. 2017 May 12;17(1):325. doi: 10.1186/s12885-017-3323-4.
BACKGROUND
Neoadjuvant fluoropirimidine (5FU)-based chemoradiotherapy (CRT) has been considered the standard of care for locally advanced rectal cancer (LARC). Whether addition of oxaliplatin (OXP) will further improve clinical outcomes is still debated. We conducted a meta-analysis to evaluate the role of OXP in this patient population.
METHODS
Literature searches were carried out in PubMed, Medline and Scopus databases. End points were overall survival (OS), disease free survival (DFS), local failure (LF) and distant failure (DF). Odd ratio (OR) with 95% confidence interval (CI) was calculated using random effects model.
RESULTS
Four randomized trials were included. Patients treated with OXP-5FU CRT had significantly decreased DF (OR = 0.76; 95% CI, 0.60 to 0.97; p = 0.03) compared to standard CRT. OS, DFS and LF were not significantly different between groups.
CONCLUSIONS
OXP significantly decreased DF, but does not improve OS e DFS compared to 5FU CRT. Precise role of OXP in neoadjuvant setting of LARC remains to be determined.
背景
基于氟尿嘧啶（5FU）的新辅助放化疗（CRT）一直被视为局部晚期直肠癌（LARC）的标准治疗方案。添加奥沙利铂（OXP）是否会进一步改善临床疗效仍存在争议。我们进行了一项荟萃分析，以评估奥沙利铂在该患者群体中的作用。
方法
在PubMed、Medline和Scopus数据库中进行文献检索。终点指标为总生存期（OS）、无病生存期（DFS）、局部复发（LF）和远处转移（DF）。采用随机效应模型计算95%置信区间（CI）的比值比（OR）。
结果
纳入四项随机试验。与标准CRT相比，接受奥沙利铂-5FU CRT治疗的患者远处转移显著降低（OR = 0.76；95% CI，0.60至0.97；p = 0.03）。两组间的总生存期、无病生存期和局部复发无显著差异。
结论
与5FU CRT相比，奥沙利铂显著降低了远处转移，但未改善总生存期和无病生存期。奥沙利铂在LARC新辅助治疗中的确切作用仍有待确定。
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