% % ~ (1) : 50% ; (2) : ( (nasopharyngeal carcinomanpc) ( / ) ) + (3) : [1] ( ) A vs. A; vs. ; + A vs. B; (4) : 1 3 ( (WHO 0

Size: px

Start display at page:

Download "12 2009 9 3 90% 1.1 75% 1.1.1 ~ (1) : 50% ; (2) : ( (nasopharyngeal carcinomanpc) ( / ) ) + (3) : [1] ( ) A vs. A; vs. ; + A vs. B; (4) : 1 3 ( (WHO 0"

富竞钱
9 years ago
Views:

1 The Journal of EvidenceBased Medicine Jun Vol.9 No.3 a b c d d a a ( a. ; b. ; c. ; d ) [ ] Cochrane Cochrane MEDLINE EMBASE OVID CBM CNKI EBSCO RevMan GP ( + )FP ( + )1 3 GP [ % ( ) P=0.02];GP ( + )GEM( ) [ % ( ) P=0.03]1 [ % ( ) P=0.04]3 ;GEM + CBP ( )DOC + DDP ( ) P<0.01; (P=0.013) 1 (P=0.018) (P=0.013) [ ] ; ; ; [ ] R739.3 [ ] A [ ] (2009) A Systematic Review of Gemcitabine for the Treatment of Advanced Nasopharyngeal Carcinoma ZHONG Jinghua a LIU Ruilin b CHEN Jing c ZHANG Jiren d HU Xigang d WANG Liqing a WANG Yong a (a. Department of Pharmacy; b. Administrative Department; c. Department of Information; d. Department of Oncology Zhujiang Hospital Southern Medical University Guangzhou China) Abstract: Objective To evaluate the role of Gemcitabine in the treatment of advanced nasopharyngeal carcinoma (NPC).Methods Up to 2008 we searched the Cochrane Library MEDLINE EMBASE OVID CBM CNKI and EBSCO. The quality of included studies was evaluated and analyses were performed for the results of homogeneous studies by RevMan software. Results 8 studies involving 482 participants with NPC were included. Analyses showed that 1 and 3 year survival rate of GP (Gemcitabine + Cisplatin) regimen had no significant difference compared with FP regimen (Fluorouracil + Cisplatin) but had higher remission rate [RR= %CI( ) P=0.02]; The response rate and 1 year survival rate of GP (Gemcitabine + Cisplatin) regimen was higher than that of monotherapy with Gemcitabine [RR= %CI( ) P=0.03] [RR= %CI( ) P=0.04] but it had no significant difference between the two regimens in 3 year survival rate; the remission rate of GEM + CBP (Gemcitabine + Carboplatin) regimen was significant higher compared with DOC + DDP regimen (Paclitaxel + Cisplatin) (P<0.01). Compared with different mode of administration there is higher response rate (P=0.013) 1 year survival rate (P=0.018) and longer median survival time(p=0.013) when Gemcitabine was administered by artery than venous. Conclusions Gemcitabine is an effective agent for NPC whatever used as monotherapy or combined treatment. Key words: nasopharyngeal neoplasms; Gemcitabine; chemotherapy; systematic review [ ] (2008B ); ( ); ( ) [ ] (1981) [ ] Tel: ; [email protected] Tel: ; [email protected]

3 [ ] A [ ] 1715144(2009)0301107 A Systematic Review of Gemcitabine for the Treatment of Advanced Nasopharyngeal Carcinoma ZHONG Jinghua a LIU Ruilin b CHEN Jing c ZHANG Jiren d HU Xigang d WANG

2 % % ~ (1) : 50% ; (2) : ( (nasopharyngeal carcinomanpc) ( / ) ) + (3) : [1] ( ) A vs. A; vs. ; + A vs. B; (4) : 1 3 ( (WHO 0~ ) ) DNA [2] ;3 ( (dfdcmp) (dfdcdp) );4 (dfdctp)dfdctp DNA DNA (completed responsecr) (partial remissionpr) (stable diseasesd) (PD) (CR) [3] FDA (progressive diseasepr) 1 3 WHO ~ ) EMBASE ( ) ( ) ( ) Cochrane EBSCO ;2 (WHO) : MEDLINE ( OVID

3 : nasopharyngeal carcinoma nasopharyngeal cancer :1 nasopharyngeal neoplasm NPC NPCa gemcitabine ;2 gemzar : ( ) ; Cochrane RevMan χ Juni [4] Cochrane : : : 95% (comfidence ; : intervalci) 95%CI 1 P > ; 0.05 ;95%CI 1 : ( 1 1) P< : 1..3 ; : ; : ( ; : ) [ 3 : (odds ratioor) (relative riskrr)] ;4 : 10% (intention to treatitt) 1..4 A B C : A : α=0.1;i 2 I 2 <25% 25%< I 2 <50% I 2 >50% (random effects model) ;B : 1 1 (fixed effects model) (OR) ; ; C : 1 1 (weighted mean differencewmd) 95%CI 1.5 (RR) RR>

05 ;95%CI 1 : ( 1 1) P<0.05 2 : 1..3 ; : ; : ( ; : ) [ 3 : (odds ratioor) (relative riskrr)] ;4 : 10% (intention to treatitt) 1..4 A B C : A : 4.

4 [13] [12] [101213] (1) 10 RCT [5] 2 8 [714] 8 RCT [71114] 1 1 Jadad KPS (%) 1 3 B 2004 GEM mg / m 2 d1 d8 d15+cddp mg / m 2 d1 # +RT 5FU mg / m 2 d1~d5+cddp mg / m 2 d1 # +RT (3 / 4).(4 / ) 50.0(2 / 4) 33.3(2 / ) [8] 2005 C GEM mg / m 2 d1 d8+cddp 70 mg / m 2 d2 * 12 5FU mg / m 2 +CDDP 70 mg / m 2 d2 * (12 / 12) (12 / 12) 91.(11 / 12) 33.3(4 / 12) [9] 200 B GEM 200 mg / m 2 d1 d7+cddp mg / m 2 d1 # +RT 5FU 500 mg / m 2 d1~d5+cddp 25 mg / m 2 d1~d5 # +RT (90 / 93) 94.(89 / 94) 75.2(70 / 93) 70.2( / 94) Yau TK [10] 200 C GEM mg / m2 d1 d8+cddp mg / m 2 d1 * 34 5FU mg / m 2 d1~d5+cddp mg / m 2 d1 * (30 / 34) 7.8(19 / 28) 73.5(25 / 34) 50(14 / 28) [11] B 2005 GEM mg / m 2 d1 d8+cbp 400 mg / m 2 d1 # 30 DOC 135 mg / m 2 d1+cddp 30 mg / m 2 d1~d3 # > > >50 > Ma BB [12] 2002 A GEM mg / m 2 d1 d8 d15 # 18 GEM mg / m 2 d1 d8 d15+cddp 70 mg / m 2 d2 # (8 / 18) 9(9 / 14) 27(4 / 18) 35(4 / 14) Foo KF [13] 2002 A GEM mg / m 2 d1 d8 * 25 GEM mg / m 2 d1 d8+cddp * (5 / 25) 4(12 / 27) 8(2 / 25) 25(7 / 27) [14] C 200 GEM 0 mg / m 2 +OXA mg / m 2 d1 d8 GEM 0 mg / m 2 +OXA mg / m 2 d1 d (19 / 25).7(14 / ) :*d / # 28 d / ;dn ;RT ;GEM: ;CDDP: ;5FU:5 ;CBP: ;DOC: 2.2 [1013] [ ] 8 RCT ;4 2 [791114] 2 [1213] RCT ;2 RCT (2) [1213] 8 RCT 2 RCT ITT [913] 3 RCT 8 RCT 4 [1114] [710] Cochrane GP FP 2 [ GP ] 1 GEM : 2 RCT A 3 B 3 C (2) ; 21 2 ; [11] + CBP DOC + DDP 1 [14] RCT (CR+PR) [71014] RCT 1 RCT

4 50 50 53 53 3 4 75(3 / 4).(4 / ) 50.0(2 / 4) 33.

5 / B [8] C [9] B Yau TK [10] C [11] B Ma BB [12] A Foo KF [13] A [14] C : : ;: ;: [ ] 3 5 RCT %(135 / 143) FP [ ] [ RCT ] 88.5%(124 / 140) [RR= RCT 95%CI( )P=0.37] RR [10] GP FP GP 3 FP 1 4 [RR= %CI ( ) ( 283 ) 1 ( P=0.09] ) α=0.1 GP FP P=0.10 I 2 =55.9%>50% [RR= %CI ( ) P= GP 0.02] (1) 95%CI GP FP GEM GP [1213] GEM [RR=1.81 [RR= 95%CI ( ) P=0.03] (3) %CI( )P=0.04] (2) GEM + CBP DOC + DDP [1213] 1 [11] GEM + CBP 3 DOC + DDP GEM [RR= %CI (0.5.05) P =0.14]

1 GP FP P=0.10 I 2 =55.9%>50% [RR=1.13 95%CI (1.021.25) P= GP 0.02] (1) 95%CI 1 2.3.1.2 3 4 1 GP FP 2.3.2 GEM GP 2.3.2.1 1 2 1 2.3.2.3 2 [1213] GEM [RR=1.

6 GEM GP 1 3 GEM GP GEM + CBP DOC + DDP 2 (P< GEM + CBP DOC + DDP )GEM + CBP (70.0%) DOC + DDP (43.3%) GP FP 1 [14] GP 1 GEM 3 DDP 5FU 42 GEM + CBP DOC + DDP 71.4% 38.1% (P=0.030); %.7% 1 (P= 0.018); 1 14 (P=0.013) ; 3 8 RCT GP FP 2 GP 1 FP RCT

3%) 2.3.4 GP FP 1 [14] 1 3 5 GP 1 GEM 3 DDP 5FU 42 GEM + CBP DOC + DDP 71.

7 [5] [J] (5):1820. [9]. [] [8]. 52 [J] (9):5759. Jiang Y Wei YQ Luo F et al. Gemcitabine and Cisplatin in advanced nasopharyngeal carcinoma: A pilot study [J]. Cancer Investigation (2): [J] (3)... + ~a [J] (): [10] Yau TK Lee AW Wong DH et al. Treatment of stage (AB) nasopharyngeal carcinoma by inductionconcurrent chemoradiotherapy and accelerated fractionation: Impact of! chemotherapy schemes [J]. Int J Radiat Oncol Biol Phys 200(4): [ ] [11]. [1] AlKourainy K Crissman J Ensley J et al. Excellent [J] (17): response to cisplatinumbased chemotherapy in patients with [12] Ma BB Tannock IF Pond GR et al. Chemotherapy with recurrent or previously untreated advanced nasopharyngeal Gemcitabinecontaining regimens for locally recurrent or carcinoma [J]. Am J Clin Oncol (4): metastatic nasopharyngeal carcinoma [J]. Cancer [2] Zhang SY Caamano J Cooper F et al. Immunohistochemistry (12): of CyclinD in human breast cancer [J]. Am Clin Pathol [13] Foo KF Tan EH Leong SS et al. Gemcitabie in metastatic :9598. nasopharyngeal carcinoma of the undifferentiated type [J]. Ann [3] Vignot S Besse B. Gemcitabine and non smallcell lung Oncol (1): cancer [J]. Bull Cancer 2007(94):S [14]. [4] Juni P Altman DG Egger M. Assessing the quality of 42 [J] (5): controlled clinical trials [J]. BMJ (7303):424. [ ] !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! ( 1 ) [4] [5] [] [8] [9] [10] [11] [12] (3):311. ECP [J]. [13]. ECP [14] [J] (12): ECP [J] (5):78.. ECP [J] (7): ECP IL5 [J] (): [17]. ECP IL4 IFNγ [J] (4): ECP IgE [J] (7): ECP IgE [J] (9):551. [J] (23): ECP [J] ():45.. [J] (2):757.. ECP [J] (4):13.. IL5 ECP [J] (8): [J] (3): ECP TIgE [J]. 2002(5): ECP. ECP IgE [J]. 200(4):7071. [15] [1] [18] [19] [ ]

$Treatment of stage (AB) nasopharyngeal carcinoma by inductionconcurrent chemoradiotherapy and accelerated fractionation: Impact of! chemotherapy schemes [J]. Int J Radiat Oncol Biol Phys 200(4):41010.$

®

中草药 Chinese Traditional and Herbal Drugs 第 45 卷第 15 期 214 年 8 月 2277 稳心颗粒治疗心律失常的 Meta 分析 * 何颖, 刘莹, 邹爱英天津中医药大学第二附属医院, 天津 15 摘要 : 利用 Meta 分析法评价稳心颗粒治疗心律失常的