Is concomitant radiotherapy necessary with gemcitabine-based chemotherapy in pancreatic cancer?
Is concomitant radiotherapy necessary with gemcitabine-based chemotherapy in pancreatic cancer?
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DOI：
10.3748/wjg.v20.i46.17648
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发表时间：
2014-12
影响因子：
4.3
通讯作者：
Xin Zhang;Hejing Huang;Dan Feng;De-jun Yang;Chang-ming Wang;Qing-ping Cai
中科院分区：
文献类型：
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作者：
Xin Zhang;Hejing Huang;Dan Feng;De-jun Yang;Chang-ming Wang;Qing-ping Cai
目的比较吉西他滨（GEM）联合放疗治疗胰腺癌（PC）的疗效和安全性。方法使用MEDLINE、EMBASE和Cochrane图书馆系统检索比较吉西他滨联合放疗与单独吉西他滨治疗PC的符合条件的研究。对每项研究进行质量评估。采用95%置信区间（CI）进行meta分析，研究相对风险的综合效应。结果：共纳入了来自4项原始研究的336名受试者。吉西他滨联合放疗的总生存期（HR = 0.84, 95%CI: 0.53-1.34, P = 0.48）和无进展生存期（HR = 0.99, 95%CI: 0.97-1.01, P = 0.36）与单独吉西他滨相当。此外，伴随放疗与严重（3级或以上）毒性的发生率显著升高相关，主要是贫血、白细胞减少、血小板减少、厌食、恶心/呕吐和虚弱/疲劳。结论吉西他滨为基础的化疗对PC患者放疗无效。进一步探索更好的放射治疗方法和治疗方案是必要的。
AIM To evaluate the efficacy and safety of gemcitabine (GEM) plus radiotherapy compared with GEM alone for pancreatic cancer (PC). METHODS A systematic search for eligible studies comparing gemcitabine plus radiotherapy with gemcitabine alone for PC was performed using MEDLINE, EMBASE, and the Cochrane Library. A quality assessment was performed in each study. Meta-analyses were performed to study the pooled effects of relative risk with 95% confidence interval (CI). RESULTS A total of 336 participants from four original studies were included. Gemcitabine plus radiotherapy resulted in comparable overall survival (HR = 0.84, 95%CI: 0.53-1.34, P = 0.48) and progress free survival (HR = 0.99, 95%CI: 0.97-1.01, P = 0.36) to gemcitabine alone. Moreover, concomitant radiotherapy was associated with a significantly higher incidence of severe (grade 3 or greater) toxicities, mainly anemia, leukocytopenia, thrombocytopenia, anorexia, nausea/vomiting, and asthenia/fatigue. CONCLUSION Radiotherapy is not beneficial with gemcitabine-based chemotherapy for PC. Further exploration for better radiotherapy approaches and therapeutic regimens for the treatment of PC is warranted.