替吉奥联合放疗治疗晚期胰腺癌的疗效及安全性Meta分析

Meta-Analysis of the Efficacy and Safety of Tegafur Combined with Radiotherapy in the Treatment of Advanced Pancreatic Cancer

摘要: 背景与目的：替吉奥联合放疗治疗晚期胰腺癌的临床疗效及安全性尚不清楚。这项研究的目的是评估替吉奥联合放疗晚期胰腺癌的疗效和安全性。方法：从建库开始到2024年10月2日，我们检索了3个中文数据库(中国知网、万方数据库、中国生物医学文献库)和4个英文数据库(PubMed、Embase、Cochrane、Web of Science)。干预组采用替吉奥联合放疗治疗，对照组采用单纯放疗治疗。主要结果为客观缓解率、1年生存率和2年生存率。次要结果是骨髓抑制、消化道反应、白细胞减少、血小板减少、贫血和肝脏损害的频率。结果：共纳入了十一项研究，涉及671名患者。替吉奥联合放疗增加了单纯放疗患者的客观缓解率(Z = 5.20, OR = 2.58, 95% CI: 1.81~3.70, P < 0.05)、1年生存率(Z = 3.92, OR = 2.16, 95% CI: 1.47~3.18, P < 0.05)和2年生存率(Z = 2.86, OR = 3.36, 95% CI: 1.46~7.70, P < 0.05)，也增加了骨髓抑制率(Z = 2.44, OR = 2.38, 95% CI: 1.19~4.78, P < 0.05)和白细胞减少率(Z = 4.39, OR = 3.30, 95% CI: 1.94~5.63, P < 0.001)。结论：替吉奥和放射治疗改善了患者的临床疗效，但也增加了骨髓抑制率和白细胞减少的发生率，但无严重不良反应，可以通过综合治疗缓解。

Abstract: Background and Purpose: The efficacy and safety of S-1 combined with radiotherapy in the treatment of advanced pancreatic cancer remain unclear. The purpose of this study is to evaluate the efficacy and safety of S-1 combined with radiotherapy for advanced pancreatic cancer. Methods: We systematically searched three Chinese databases: CNKI, WANFANG Data, CBM, and four English databases: PubMed, EMBASE, Cochrane Library, Web of Science, from foundation to 2024 October 2. The intervention was Tegaful plus radiotherapy for the experimental group and radiotherapy alone for the control group. The primary outcomes were objective response rate, 1-year survival rate and 2-year survival rate. Secondary outcomes were the frequency of myelosuppression, gastrointestinal reactions, leukopenia, thrombocytopenia, anemia, and liver damage. Results: Eleven studies involving 671 patients were included. Tegaful combined with radiotherapy increased the objective response rate (Z = 5.20, OR = 2.58, 95% CI: 1.81~3.70, P < 0.05), 1-year survival rate (Z = 3.92, OR = 2.16, 95% CI: 1.47~3.18, P < 0.05) and 2-year survival rate (Z = 2.86, OR = 3.36, 95% CI: 1.46~7.70, P < 0.05) of patients treated with radiotherapy alone. It also increased the rate of myelosuppression (Z = 2.44, OR = 2.38, 95% CI: 1.19~4.78, P < 0.05) and the rate of leukopenia (Z = 4.39, OR = 3.30, 95% CI: 1.94~5.63, P < 0.001). Conclusions: Tegaful and radiotherapy have improved the clinical efficacy of patients, but they have also increased the rate of bone marrow suppression and the incidence of leukopenia. However, there are no serious adverse reactions, which can be alleviated through comprehensive treatment.