
目的 系统评价阿帕替尼联合SOX方案(替吉奥 + 奥沙利铂)治疗晚期胃癌的有效性和安全性。 方法 检索PubMed、Embase、Cochranelibrary、ClinicalTrials.gov、万方、中国知网,查找研究阿帕替尼联合SOX方案治疗晚期胃癌患者的有效性与安全性的随机对照试验。对纳入的文献进行数据提取,主要结局指标为客观缓解率(objective response rate, ORR)、疾病控制率(disease control rate, DCR);次要结局指标为部分缓解率(partial response rate, PRR)、安全性相关指标(高血压、蛋白尿、手足综合征、腹泻、口腔黏膜炎、疲劳、白细胞减少症、血小板减少症等不良反应的发生人数)。应用R 4.0.3进行统计分析,应用RevMan 5.3进行质量评价图的制作。 结果 共检索到1 699篇文献,最终纳入28项研究,包含2 110例患者。相较于SOX方案,阿帕替尼联合SOX方案能够提高患者DCR(OR = 3.90,95% CI:3.15 ~ 4.83,P < 0.001)、ORR(OR = 2.73,95% CI:2.26 ~ 3.31,P < 0.001)、PRR(OR = 2.33,95% CI:1.94 ~ 2.81,P < 0.001),差异有统计学意义。该治疗方案的药品不良反应:高血压(OR = 2.47,95% CI:1.26 ~ 4.83,P = 0.008)、蛋白尿(OR = 2.16,95% CI:1.46 ~ 3.21,P < 0.001)、手足综合征(OR = 2.19,95% CI:1.44 ~ 3.32,P < 0.001)的发生率增加,差异有统计学意义。 结论 本荟萃分析结果表明,阿帕替尼联合SOX方案治疗晚期胃癌有效性显著,不良反应相对轻微,有望在临床上得到应用。
","endNoteUrl_en":"http://xuebao.sdfmu.edu.cn/EN/article/getTxtFile.do?fileType=EndNote&id=651","reference":"1 | Zhong DT, Wu RP, Wang XL, et al. Combination chemotherapy with S-1 and oxaliplatin (SOX) as first-line treatment in elderly patients with advanced gastric cancer[J]. Pathol Oncol Res, 2015, 21(4): 867. |
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7 | 徐亮, 梁文昌, 阚随随, 等. 阿帕替尼治疗晚期胃癌的临床疗效及预后[J]. 深圳中西医结合杂志, 2019, 29(1): 161. |
8 | 刘欣. 阿帕替尼治疗胃癌和食管胃结合部腺癌伴肝转移患者的临床效果分析[J]. 名医, 2019(2): 243. |
9 | 杨庆伟, 梁海鹏, 陈小鹏, 等. 低剂量阿帕替尼联合SOX方案治疗晚期胃癌的临床研究[J]. 临床研究, 2020, 28(7): 38. |
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13 | 李淼, 晋国权, 陈蓉, 等. 甲磺酸阿帕替尼联合SOX方案二线治疗晚期胃癌的近期疗效及安全性[J]. 中国中西医结合消化杂志, 2018, 26(9): 736. |
14 | 赵妙妙, 杨家梅, 匡菁. 甲磺酸阿帕替尼联合化疗治疗晚期胃癌合并顽固性癌性腹水的临床疗效观察[J]. 世界最新医学信息文摘, 2019, 19(71): 236. |
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18 | 郝玉莲. SOX方案化疗+阿帕替尼在胃癌患者Ⅲ~Ⅳ期中的临床应用价值[J]. 临床研究, 2020, 28(9): 62. |
19 | 韩忠诚, 马丽丽, 崔智文, 等. SOX方案联合阿帕替尼一线治疗晚期胃癌的临床研究[J]. 中国癌症防治杂志, 2019, 11(1): 62. |
20 | 郭炜, 赵苗苗, 赵丽香, 等. SOX方案联合甲磺酸阿帕替尼治疗晚期不可手术切除胃癌患者的临床疗效评价[J]. 肿瘤药学, 2021, 11(5): 601. |
21 | 文江民. 阿帕替尼、奥沙利铂、替吉奥三药联用对晚期胃癌的价值分析[J]. 中国处方药, 2020, 18(6): 114. |
22 | 张曌星, 李智梅. 阿帕替尼联合SOX方案化疗对晚期胃癌患者生存质量的影响[J]. 黑龙江医药科学, 2021, 44(2): 149. |
23 | 齐锦宏. 阿帕替尼联合SOX化疗对胃癌患者疾病控制率及血清SIL-2R、VEGF水平的影响[J]. 河南医学研究, 2020, 29(4): 677. |
24 | 赵向千. 阿帕替尼联合SOX化疗方案治疗33例晚期胃癌患者的临床研究[J]. 黑龙江医药, 2018, 31(6): 1267. |
25 | 夏浩沄. 阿帕替尼联合SOX化疗方案治疗晚期胃癌的临床效果[J]. 慢性病学杂志, 2020, 21(11): 1681. |
26 | 黄俊婷. 阿帕替尼联合SOX化疗方案治疗晚期胃癌临床观察[J]. 肿瘤基础与临床, 2018, 31(5): 416. |
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Objective A Meta-analysis was conducted to systematically analyze the efficacy and safety of apatinib combined with SOX regime(oxaliplatin+tegafur)in patients with advanced gastric cancer. Methods PubMed, Embase, Cochrane Library, ClinicalTrials.gov, WANFANG DATA and CNKI were searched for randomized controlled trials studying the efficacy and safety of apatinib combined with SOX in the treatment of advanced gastric cancer patients. Data were extracted from the included literature, and the main outcome indicators were as follows: objective response rate (ORR), disease control rate (DCR); secondary outcome indicators: partial response rate (PRR) and safety related indicators, including hypertension, proteinuria, hand-foot syndrome, diarrhea, oral mucositis, fatigue, leukopenia, thrombocytopenia. All statistical analyses were performed using meta package for R version 4.0.3. Results 1699 articles were retrieved and 28 articles with a total of 2110 subjects were ultimately included. Compared with SOX regimen, apatinib combined with SOX regimen improved DCR (OR = 3.90, 95% CI: 3.15 - 4.83, P < 0.001) and ORR (OR = 2.73, 95% CI: 2.26 - 3.31, P < 0.001), PRR (OR = 2.33, 95% CI: 1.94 - 2.81, P < 0.001), but increased hypertension (OR = 2.47, 95% CI: 1.26-4.83, P = 0.008), proteinuria (OR = 2.16, 95% CI: 1.46-3.21, P < 0.001), hand-foot syndrome (OR = 2.19, 95% CI: 1.44 - 3.32, P < 0.001). The difference was statistically significant. Conclusion The results of this meta-analysis showed that apatinib combined with SOX regime was effective in the treatment of advanced gastric cancer with relatively mild adverse events, which is expected to be applied in clinical practice.
","bibtexUrl_en":"http://xuebao.sdfmu.edu.cn/EN/article/getTxtFile.do?fileType=BibTeX&id=651","abstractUrl_cn":"http://xuebao.sdfmu.edu.cn/CN/10.3969/j.issn.2097-0005.2024.05.003","zuoZheCn_L":"热依拉·阿布都肉苏力, 李胜, 葛蒲, 韩笑, 张清霜","juanUrl_cn":"http://xuebao.sdfmu.edu.cn/CN/Y2024","lanMu_en":"Clinical Researches","qiUrl_en":"//www.pitakata.com/xuebao/EN/Y2024/V45/I5","zuoZhe_EN":"Abudurousuli Reyila1, Sheng LI2, Pu GE3, Xiao HAN4, Qingshuang ZHANG5(A Meta-analysis of the efficacy and safety of apatinib combined with SOX regime in patients with advanced gastric cancer
Abudurousuli Reyila, Sheng LI, Pu GE, Xiao HAN, Qingshuang ZHANG
Journal of ShanDong First Medical University&ShanDong Academy of Medical Sciences››2024, Vol. 45››Issue (5): 269-277.
A Meta-analysis of the efficacy and safety of apatinib combined with SOX regime in patients with advanced gastric cancer
ObjectiveA Meta-analysis was conducted to systematically analyze the efficacy and safety of apatinib combined with SOX regime(oxaliplatin+tegafur)in patients with advanced gastric cancer.MethodsPubMed, Embase, Cochrane Library, ClinicalTrials.gov, WANFANG DATA and CNKI were searched for randomized controlled trials studying the efficacy and safety of apatinib combined with SOX in the treatment of advanced gastric cancer patients. Data were extracted from the included literature, and the main outcome indicators were as follows: objective response rate (ORR), disease control rate (DCR); secondary outcome indicators: partial response rate (PRR) and safety related indicators, including hypertension, proteinuria, hand-foot syndrome, diarrhea, oral mucositis, fatigue, leukopenia, thrombocytopenia. All statistical analyses were performed using meta package for R version 4.0.3.Results1699 articles were retrieved and 28 articles with a total of 2110 subjects were ultimately included. Compared with SOX regimen, apatinib combined with SOX regimen improved DCR (OR= 3.90, 95%CI: 3.15 - 4.83,P< 0.001) and ORR (OR= 2.73, 95%CI: 2.26 - 3.31,P< 0.001), PRR (OR= 2.33, 95%CI: 1.94 - 2.81,P< 0.001), but increased hypertension (OR= 2.47, 95%CI: 1.26-4.83,P= 0.008), proteinuria (OR= 2.16, 95%CI: 1.46-3.21,P< 0.001), hand-foot syndrome (OR= 2.19, 95%CI: 1.44 - 3.32,P< 0.001). The difference was statistically significant.ConclusionThe results of this meta-analysis showed that apatinib combined with SOX regime was effective in the treatment of advanced gastric cancer with relatively mild adverse events, which is expected to be applied in clinical practice.
1 | Zhong DT, Wu RP, Wang XL, et al. Combination chemotherapy with S-1 and oxaliplatin (SOX) as first-line treatment in elderly patients with advanced gastric cancer[J].Pathol Oncol Res,2015,21(4): 867. |
2 | 李春杏, 刘桦, 由凯. 阿帕替尼治疗晚期胃癌患者的疗效和安全性的荟萃分析[J].药学服务与研究,2019,19(1): 41. |
3 | Jiang D, Xu Y, Chen Y, et al. Apatinib combined with SOX regimen in conversion treatment of advanced gastric cancer: a case series and literature review[J].Front Pharmacol,2020,11: 1027. |
4 | 朱淑娟. 阿帕替尼治疗晚期转移或复发性胃癌的临床观察[J].医学理论与实践,2019,32(15): 2405. |
5 | 刘盈海, 坚胜强. 阿帕替尼片联合奥沙利铂注射液和替吉奥胶囊治疗晚期胃癌的效果及安全性[J].中国处方药,2019,17(8): 84. |
6 | 文峰, 向燕, 王雷. 阿帕替尼片治疗晚期胃癌的临床研究[J].中国临床药理学杂志,2017,33(7): 589. |
7 | 徐亮, 梁文昌, 阚随随, 等. 阿帕替尼治疗晚期胃癌的临床疗效及预后[J].深圳中西医结合杂志,2019,29(1): 161. |
8 | 刘欣. 阿帕替尼治疗胃癌和食管胃结合部腺癌伴肝转移患者的临床效果分析[J].名医,2019(2): 243. |
9 | 杨庆伟, 梁海鹏, 陈小鹏, 等. 低剂量阿帕替尼联合SOX方案治疗晚期胃癌的临床研究[J].临床研究,2020,28(7): 38. |
10 | 韩笑. 低剂量阿帕替尼联合SOX方案治疗晚期胃癌的效果观察[J].中国现代药物应用,2021,15(9): 179. |
11 | 朱亚军, 钱军. 低剂量阿帕替尼联合化疗治疗晚期胃癌的疗效及安全性分析[J].临床医药文献电子杂志,2019,6(A3): 12. |
12 | 汪斐, 刘佩, 黄雯, 等. 甲磺酸阿帕替尼对晚期胃癌患者临床疗效及预后的影响[J].国际感染病学(电子版),2019,8(3): 93. |
13 | 李淼, 晋国权, 陈蓉, 等. 甲磺酸阿帕替尼联合SOX方案二线治疗晚期胃癌的近期疗效及安全性[J].中国中西医结合消化杂志,2018,26(9): 736. |
14 | 赵妙妙, 杨家梅, 匡菁. 甲磺酸阿帕替尼联合化疗治疗晚期胃癌合并顽固性癌性腹水的临床疗效观察[J].世界最新医学信息文摘,2019,19(71): 236. |
15 | 郭军, 王娜, 刘登湘, 等. 甲磺酸阿帕替尼片联合替吉奥和奥沙利铂治疗晚期胃癌的效果与安全性[J].中国医药,2020,15(4): 577. |
16 | 马宁. 晚期胃癌患者接受阿帕替尼片联合奥沙利铂注射液和替吉奥胶囊治疗的价值[J].智慧健康,2019,5(35): 149. |
17 | 李鹏, 李成浩. 晚期胃癌治疗中阿帕替尼片联合奥沙利铂注射液和替吉奥胶囊的临床疗效及安全性对比分析[J].河北医学,2017,23(11): 1923. |
18 | 郝玉莲. SOX方案化疗+阿帕替尼在胃癌患者Ⅲ~Ⅳ期中的临床应用价值[J].临床研究,2020,28(9): 62. |
19 | 韩忠诚, 马丽丽, 崔智文, 等. SOX方案联合阿帕替尼一线治疗晚期胃癌的临床研究[J].中国癌症防治杂志,2019,11(1): 62. |
20 | 郭炜, 赵苗苗, 赵丽香, 等. SOX方案联合甲磺酸阿帕替尼治疗晚期不可手术切除胃癌患者的临床疗效评价[J].肿瘤药学,2021,11(5): 601. |
21 | 文江民. 阿帕替尼、奥沙利铂、替吉奥三药联用对晚期胃癌的价值分析[J].中国处方药,2020,18(6): 114. |
22 | 张曌星, 李智梅. 阿帕替尼联合SOX方案化疗对晚期胃癌患者生存质量的影响[J].黑龙江医药科学,2021,44(2): 149. |
23 | 齐锦宏. 阿帕替尼联合SOX化疗对胃癌患者疾病控制率及血清SIL-2R、VEGF水平的影响[J].河南医学研究,2020,29(4): 677. |
24 | 赵向千. 阿帕替尼联合SOX化疗方案治疗33例晚期胃癌患者的临床研究[J].黑龙江医药,2018,31(6): 1267. |
25 | 夏浩沄. 阿帕替尼联合SOX化疗方案治疗晚期胃癌的临床效果[J].慢性病学杂志,2020,21(11): 1681. |
26 | 黄俊婷. 阿帕替尼联合SOX化疗方案治疗晚期胃癌临床观察[J].肿瘤基础与临床,2018,31(5): 416. |
27 | 郑雷振. 阿帕替尼联合奥沙利铂、替吉奥治疗晚期胃癌的临床观察[J].临床医学,2021,41(5): 107. |
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