Systematic review of the predictive effect of MSI status in colorectal cancer patients undergoing 5FU-based chemotherapy.
Systematic review of the predictive effect of MSI status in colorectal cancer patients undergoing 5FU-based chemotherapy.
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DOI：
10.1186/s12885-015-1093-4
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发表时间：
2015-03-21
期刊：
影响因子：
3.8
通讯作者：
Goddard KA
中科院分区：
文献类型：
--
作者：
Webber EM;Kauffman TL;O'Connor E;Goddard KA
我们系统地回顾了结直肠癌中微卫星不稳定状态 (MSI) 与 5FU 治疗相互作用的证据，以确定 MSI 状态如何预测接受基于 5FU 化疗的患者的健康结果。截至 2013 年 6 月，我们对四个电子数据库进行了检索。我们考虑的研究包括接受基于 5FU 化疗的结直肠癌患者和未接受治疗且生存结果由 MSI 状态呈现的患者。我们确定了 16 项研究进行定性分析（9,212 名患者），其中 14 项研究符合荟萃分析条件。微卫星稳定 (MSS) 组显示 5FU 治疗对无病生存期（HR 为 0.62 [95% CI: 0.54, 0.71]）和总生存期（HR 为 0.65 [95% CI: 0.54, 0.79]）有影响，表明接受 5FU 治疗的 MSS 患者比未治疗的 MSS 患者生存期更长。对于高微卫星 (MSI-H) 患者，5FU 治疗的无病生存率（HR 0.84 [95% CI: 0.53, 1.32]）或总生存率（HR 0.66 [95% CI: 0.43, 1.03]）的效果不具有统计学意义。然而，MSS 和 MSI-H 组 5FU 治疗效果的总结点估计在统计显着水平上没有差异。我们的分析表明，基于 5FU 的化疗可提高 CRC 患者的无病生存率和总生存率，但基于 MSI 状态的治疗效果没有差异。因此，使用 MSI 状态来指导 5FU 治疗 CRC 的治疗决策对患者没有显着益处。本文的在线版本 (doi:10.1186/s12885-015-1093-4) 包含补充材料，可供授权用户使用。
We systematically reviewed the evidence for the interaction of microsatellite instability status (MSI) and treatment with 5FU in colorectal cancer to determine how well MSI status predicts health outcomes in patients undergoing 5FU-based chemotherapy. We conducted a search of four electronic databases through June 2013. We considered studies that included both colorectal cancer patients treated with 5FU-based chemotherapy and untreated patients with survival outcomes presented by MSI status. We identified 16 studies for qualitative analysis (9,212 patients) with 14 studies eligible for meta-analysis. The microsatellite stable (MSS) group showed an effect of 5FU treatment on disease-free survival (HR of 0.62 [95% CI: 0.54, 0.71]) and overall survival (HR of 0.65 [95% CI: 0.54, 0.79]), indicating that MSS patients who received 5FU treatment had longer survival than MSS patients who were untreated. The effect of 5FU treatment was not statistically significant for microsatellite high (MSI-H) patients for disease-free survival (HR of 0.84 [95% CI: 0.53, 1.32]) or overall survival (HR 0.66 [95% CI: 0.43, 1.03]). However, the summarized point estimates of the effects of 5FU treatment for the MSS and MSI-H groups were not different at a statistically significant level. Our analyses indicate that treatment with 5FU-based chemotherapy improves disease-free and overall survival in CRC patients, but that there is no difference in the effect of treatment based on MSI status. Therefore, the use of MSI status to guide treatment decisions about the use of 5FU treatment for CRC has no significant benefits for patients. The online version of this article (doi:10.1186/s12885-015-1093-4) contains supplementary material, which is available to authorized users.
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DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
45.3
作者：
Bertagnolli, Monica M.;Redston, Mark;Warren, Robert S.
通讯作者：
Warren, Robert S.
影响因子：
6.4
作者：
Dietmaier, W;Bettstetter, M;Hofstädter, F
通讯作者：
Hofstädter, F
影响因子：
2.2
作者：
Chu, Hui-Ying;Zheng, Qing-Chuan;Zhang, Hong-Xing
通讯作者：
Zhang, Hong-Xing
影响因子：
8.4
作者：
Guastadisegni, Cecilia;Colafranceschi, Mauro;Dogliotti, Eugenia
通讯作者：
Dogliotti, Eugenia