2种化疗药联合治疗中国人群胃癌的网状Meta分析OACSTPCD

OBJECTIVE:To systematically review the efficacy of combination of two chemotherapeutic drugs in the treatment of gastric cancer in Chinese population.METHODS:PubMed,Embase,Web of Science,the Cochrane Library,CNKI,CBM,Wanfang Data and VIP were retrieved to collect clinical studies on the treatment of gastric cancer with the combination of S-1,oxaliplatin,cisplatin,capecitabine,irinotecan and docetaxel published at home and abroad.The retrieval time was from the database establishment to Apr.1st,2022.RevMan 5.4 software was used for bias evaluation,and Stata 14.2 software was used for network Meta-analysis.RESULTS:A total of 132 studies(dual-arm clinical trials)including 9680 patients and 10 drug combinations were enrolled,respectively XELOX regimen(oxaliplatin+capecitabine),SOX regimen(oxaliplatin+S-1),SP regimen(S-1+cisplatin),XP regimen(cisplatin+capecitabine),DP regimen(cisplatin+docetaxel),DX regimen(capecitabine+docetaxel),DS regimen(S-1+docetaxel),OXA+DOC regimen(oxaliplatin+docetaxel),CapIRI regimen(capecitabine+irinotecan),and S-1+IRI regimen(S-1+irinotecan).Results of network Meta-analysis showed that the effective rates from high to low were DS regimen,SOX regimen,S-1+IRI regimen,CapIRI regimen,XELOX regimen,OXA+DOC regimen,DX regimen,SP regimen,DP regimen and XP regimen,the effective rates of DS regimen,SOX regimen and XELOX regimen were better than those of SP regimen and XP regimen,the differences were statistically significant(P<0.05).The disease control rate from high to low was SOX regimen,OXA+DOC regimen,DS regimen,XELOX regimen,CapIRI regimen,SP regimen,DX regimen,S-I+IRI regimen,DP regimen and XP regimen,the disease control rates of DS regimen,SOX regimen and XELOX regimen were better than those of XP regimen,the differences were statistically significant(P<0.05).DS regimen had the lowest incidence of anemia and nephrotoxicity,SOX regimen had the lowest incidence of leukopenia and diarrhea,XELOX regimen had the lowest incidence of thrombocytopenia.DX regimen had the lowest incidence of nausea,vomiting,stomatitis and hepatotoxicity,DP regimen had the lowest incidence of neurotoxicity,and SP regimen had the lowest incidence of hand-foot syndrome.CONCLUSIONS:Available evidence suggests that the chemotherapeutic combination of SOX regimen,DS regimen,XELOX regimen,S-1+IRI regimen and CapIRI regimen are effective in terms of both efficiency and disease control rate,and XP regimen is the worst in terms of both efficiency and disease control rate.