Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, 110001, China.
Sci Rep. 2017 Jul 13;7(1):5319. doi: 10.1038/s41598-017-05464-0.
Taxanes are chemotherapeutic agents commonly used to treat several cancers. However, the effects of taxanes on advanced gastric cancer (AGC) are still not clear, especially when used as a first-line treatment. This systematic review and meta-analysis aims to investigate the efficacy and safety of taxanes as a first-line treatment of AGC. The quality of our included studies was assessed using the Cochrane risk of bias tool for RCTs and NOS scale for nRCTs, and the data of the included studies was of satisfactory quality to analyze. The outcomes included overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and toxicity. Taxanes significantly improved OS (HR = 0.84, 95% CI 0.76-0.92, P = 0.0004) and had a slight effect on ORR (RR = 1.23, 95% CI 1.00-1.51, P = 0.05). However, taxanes may also increase the risks of neutropenia and leucopenia, similar to effects observed in other conventional chemotherapeutic treatments such as oxaliplatin and epirubicin. Therefore, patient characteristics including concomitant diseases, physical condition, and prior therapies should be considered before selecting taxane-based treatments for AGC.
紫杉烷类药物是一种常用于治疗多种癌症的化疗药物。然而，紫杉烷类药物在晚期胃癌（AGC）中的作用尚不清楚，特别是作为一线治疗药物时。本系统评价和荟萃分析旨在研究紫杉烷类药物作为 AGC 一线治疗的疗效和安全性。我们使用 Cochrane RCT 偏倚风险工具和 NOS nRCT 量表评估纳入研究的质量，并且纳入研究的数据质量足以进行分析。结局包括总生存期（OS）、无进展生存期（PFS）、总缓解率（ORR）和毒性。紫杉烷类药物显著改善了 OS（HR=0.84，95%CI 0.76-0.92，P=0.0004），对 ORR 有轻微影响（RR=1.23，95%CI 1.00-1.51，P=0.05）。然而，紫杉烷类药物也可能增加中性粒细胞减少和白细胞减少的风险，与奥沙利铂和表柔比星等其他常规化疗药物观察到的作用相似。因此，在选择基于紫杉烷类药物治疗 AGC 之前，应考虑患者的特征，包括合并症、身体状况和既往治疗。
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