Toxicity of chemotherapy regimens in advanced and metastatic pancreatic cancer therapy: A network meta-analysis
Toxicity of chemotherapy regimens in advanced and metastatic pancreatic cancer therapy: A network meta-analysis
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DOI：
10.1002/jcb.26266
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发表时间：
2018-07-01
影响因子：
4
通讯作者：
Jiang, Ji-Hao
中科院分区：
文献类型：
--
作者：
Wang, Xiao-Fang;Huang, Wen-Feng;Jiang, Ji-Hao
本网络荟萃分析是为了比较不同化疗方案治疗晚期/转移性胰腺癌（PC）的毒性。该网络荟萃分析使用Cochrane图书馆和PubMed电子数据库，纳入了关于晚期/转移性PC不同化疗方案的随机对照试验（rct）。通过网络荟萃分析，将直接和间接证据结合起来，计算奇数比（OR），并在累积排名（SUCRA）曲线下绘制曲面。本网络荟萃分析共纳入19项随机对照试验，包括12种化疗方案（吉西他滨、吉西他滨+S-1[替加富]、吉西他滨+纳贝-紫杉醇、吉西他滨+卡培他滨、吉西他滨+顺铂、FOLFIRINOX[奥沙利铂+伊立替康+氟尿嘧啶+亚叶酸]、吉西他滨+奥沙利铂、吉西他滨+伊立替康、吉西他滨+艾替康、吉西他滨+培美曲塞、吉西他滨+5-FU、S-1）。吉西他滨+卡培他滨方案贫血发生率高于吉西他滨方案，吉西他滨+培美曲塞方案贫血和中性粒细胞减少发生率最高；而吉西他滨+S-1、吉西他滨+顺铂和FOLFIRINOX方案中性粒细胞减少发生率最高。然而，S-1方案显示白细胞减少和血小板减少的发生率较低。吉西他滨+S-1方案恶心/呕吐和皮疹发生率高于吉西他滨方案，吉西他滨+顺铂方案恶心/呕吐发生率最高。本研究显示S-1方案的血液学毒性最低，而吉西他滨方案的非血液学毒性发生率最低，为晚期/转移性PC的治疗提供指导。
This network meta-analysis is adopted in order to compare the toxicity of different chemotherapy regimens in the treatment of advanced/metastatic pancreatic cancer (PC). Randomized controlled trials (RCTs) about different chemotherapy regimens for advanced/metastatic PC were included in this network meta-analysis using Cochrane Library and PubMed electronic databases. The network meta-analysis was performed to combine direct and indirect evidence in order to calculate the odd ratios (OR) and draw a surface under the cumulative ranking (SUCRA) curve. A total of 19 RCTs were enrolled in this network meta-analysis including 12 chemotherapy regimens (Gemcitabine, Gemcitabine+S-1 [tegafur], Gemcitabine+nab-paclitaxel, Gemcitabine+Capecitabine, Gemcitabine+Cisplatin, FOLFIRINOX [oxaliplatin+irinotecan+fluorouracil+leucovorin], Gemcitabine+oxaliplatin, Gemcitabine+irinotecan, Gemcitabine+Exatecan, Gemcitabine+pemetrexed, Gemcitabine+5-FU, S-1). The incidence of anemia of Gemcitabine+Capecitabine regimen was higher compared with Gemcitabine regimen, Gemcitabine+pemetrexed regimen exhibited the highest incidence rates of anemia and neutropenia; while Gemcitabine+S-1, Gemcitabine+Cisplatin and FOLFIRINOX regimens exhibited the highest incidence rates of neutropenia. However, S-1 regimen exhibited lower incidence rates of leukopenia and thrombocytopenia. Moreover, the incidence rates of nausea/vomiting and rash of Gemcitabine+S-1 regimen were higher compared with Gemcitabine regimen, while Gemcitabine+Cisplatin regimen had the highest incidence rate of nausea/vomiting. This study demonstrated that the hematologic toxicity of S-1 regimen was the lowest, while Gemcitabine regimen exhibited the lowest incidence rate of non-hematologic toxicity, providing guidance for the treatment of advanced/metastatic PC.