• 1. 中南大學湘雅醫(yī)院消化內科, 長沙 410078　2. 中南大學湘雅二醫(yī)院, 長沙 410011　3. 中南大學湘雅醫(yī)學院, 長沙 410078;

目的　 評價10-羥基喜樹堿治療胃腸道腫瘤的近期臨床療效和安全性.
方法 　電子檢索中國學術期刊網全文數據庫(1995～2005),MEDLINE(1995～2005)和Cochrane圖書館(2005第1期),并與研究者聯系以獲得更多相關研究資料.納入比較10-羥基喜樹堿(10-HCPT)或以10-HCPT為主的二聯及多聯化療方案治療胃腸道腫瘤的隨機對照試驗,比較兩組化療有效率、消化道和血液毒性反應率.由兩名評價員獨立檢索和提取資料并交叉核對,對納入文獻的方法學質量進行評價,數據采用RevMan4.2.2版軟件進行統計分析.
結果　 共納入25個試驗,共1 881例患者.Meta分析結果提示:10-HCPT可以顯著提高近期大腸癌化療療效[OR 1.62,95%CI(1.37,1.92)]和胃癌化療療效[OR 1.48,95%CI(1.18,1.85)],其所致消化道嚴重毒性反應發(fā)生率與對照組比較差異無統計學意義[OR 0.96,95%CI(0.62,1.50)],但血液系統嚴重毒性反應發(fā)生率卻顯著增高[OR 1.27,95%CI(1.02,1.58)].
結論 　現有研究資料顯示,10-HCPT可以提高胃腸道腫瘤化療近期臨床療效,但會增加血液系統嚴重毒性反應發(fā)生率,其在改善預后方面的作用還需要進一步研究.

引用本文： 劉 祺,龔凡杰,李永國,譚澤明,周建平. 10-羥基喜樹堿治療胃腸道腫瘤近期療效及安全性的Meta分析. 中國循證醫(yī)學雜志, 2006, 06(2): 124-130. doi: 復制

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  1. 1. Cummings J,Smyth JE.DNA topoisomerase I and II as targets for rational design of new anticancer drugs.Ann Oncol;1993,4(7):533-543.
  2. 2. Sun Y,Zhou JC.Manual medical oncology.The 3rd Edition.Peiking:People’s Medical Publishing House; 1996.24-34.孫燕,周際昌.主編.臨床腫瘤內科手冊.第3版.北京:人民衛(wèi)生出版社,1996.24～34.
  3. 3. Aldeson P,Green S,Higgins JPT editors.Cochrane Reviews’Handbook 4.2.2[Updated December 2003][M/CD].In:The Cochrane Library,Issue 1,2004.Chichester,UK:John Wiley ＆Sons,Ltd.
  4. 4. He ZQ,Zhong MY,Cheng DY,et al.Clinical observation on effect of chemical therapy on patients with advanced colon cancer.Chinese Journal of Integrated Tradition-West Medical Digestion,2003; 11(2):98-99.何肇晴,鐘敏鈺,程冬英等.晚期大腸癌化療的臨床療效觀察.中國中西醫(yī)結合消化雜志,2003; 11(2):98～99.
  5. 5. Zhang L,Wang XD.A report of HCPT plus 5-Fu +CF versus 5-Fu + CF chemotherapy alone for advanced colorectal carcinoma.Henan Journal of Oncology,2001; 14(4):246-248.張力,王賢德.含羥基喜樹堿方案聯合化療晚期大腸癌的臨床觀察.河南腫瘤學雜志,2001,14(4):246～248.
  6. 6. Pan LX,Zhen XL,Huang FL,et al.Treatment of 93 cases with advanced colorectal carcinoma using a series of leucovorin plus 5-Fluorouracil regimens.China Oncology,1999; 9(3):221-223.潘良熹,鄭秀立,黃富麟等.醛氫葉酸聯合氟尿嘧啶系列方案治療93例晚期結直腸癌.中國癌癥雜志,1999; 9(3):221～223.
  7. 7. Zhao WY.Efficacy of hydroxycamptothecin based combination chemotherapy in advanced colorectal cancer.Chinese Journal of Clinical Pharmacology and Therapy,1999; 4 (4):339-340.趙文英.含羥基喜樹堿聯合化療方案治療晚期大腸癌臨床觀察.中國臨床藥理學與治療學,1999; 4(4):339～340.
  8. 8. Xu WG,Hu MQ,Jiang GF.Efficacy of hydroxycamptothecin based combination chemotherapy in advanced gastrointestinal tract cancer.Chinese Journal of Clinical Oncology,2002; 29(9):625-632.徐偉剛,胡梅齊,姜觀富.羥基喜樹堿聯合化療治療晚期胃腸道癌療效觀察.中國腫瘤臨床,2002,29(9):625～632.
  9. 9. Wu JQ,Pan LX,Feng JF,et al.Clinical observation of hydroxyl-camptothecin combination with 5-fluorouracil plus folinic acid on advanced colorectal cancer.Journal of QiLu Oncology,1997; 4(2):129-130.吳劍秋,潘良熹,馮繼峰等.羥基喜樹堿聯合氟尿嘧啶及醛氫葉酸治療晚期大腸癌臨床觀察.齊魯腫瘤雜志,1997,4(2):129～130.
  10. 10. Liu XM,Wang HQ,Cui XZ,et al.Preliminary study on HCPT combined with Leucovorin,5-Fu and cisplatin in the treatment of advanced colorectal cancer.Chinese Journal of Clinical Oncology,2001; 28(11):845-847.劉賢明,王華慶,崔秀珍等.羥基喜樹堿聯合DLF方案治療晚期大腸癌.中國腫瘤臨床,2001; 28(11):845～847.
  11. 11. Liu J,Mao XH,Ling CR,et al.Comparative clinical study of HCPT verse DDP combined chemotherapy with advanced colorectal cancer.Journal of Practical Oncology,1998; 12(1):36-37.劉健,毛雪華,林傳榮等.羥基喜樹堿/順鉑聯合方案治療晚期大腸癌德隨機性臨床研究.實用腫瘤學雜志,1998; 12(1):36～37.
  12. 12. Xu DL,Tu SP.Combined treatment of late colorectal cancer with the main HCPT.Chinese Journal of Gastroenterology and Hepatology,2001; 10(1):161-162.徐德亮,涂水平.以羥基喜樹堿為主聯合治療晚期大腸癌.胃腸病學和肝病學雜志,2001; 10(1):161～162.
  13. 13. Lu JZ,Ye YZ,Zhan Y,et al.Clinical study of advanced intestinal cancer treated by two different regimens.China Journal of Cancer Prevention and Treatment,2003; 10(11):1194-1195.盧介珍,葉勇智,詹穎等.兩種化療方案治療晚期大腸癌的臨床研究.腫瘤防治雜志,2003; 10(11):1194～1195.
  14. 14. Xie DR,Peng WJ,Chen DJ,et al.Preliminary clinical study on HCPT combined with leucovorin and 5-Fu in treating patients with advanced colorectal carcinoma.Chinese Journal of Clinical Oncology,2001; 28(10):764-766.謝德榮,彭杰文,陳岱佳等.羥基喜樹堿聯用氟脲嘧啶/醛氫葉酸治療晚期大腸癌的臨床研究.中國腫瘤臨床,2001,28(10):764～766.
  15. 15. Ren XP,Wang XG,Zhu ZK,et al.Comparative study of curative effect of combination chemotherapy with hydroxycamptothecin in advanced digestive tract tumors.Chinese Journal of Clinical Oncology Rehabilitation,2003; 10(2):169-171.任曉萍,王興國,朱增寬等.羥基喜樹堿為主聯合化療治療晚期消化道腫瘤療效對照研究.中國腫瘤臨床與康復,2003,10(2):169～171.
  16. 16. Liu P.Clinical observation on HCPT + 5-Fu + CF in the treatment of 60 cases of colorectal cancer.Chinese Journal of Clinical Oncology Rehabilitation,2004; 11(4):313-314.劉萍.羥基喜樹堿聯合化療方案治療大腸癌60例臨床觀察.中國腫瘤臨床與康復雜志,2004; 11(4):313～314.
  17. 17. Chen H,Qiu HY.Clinical observation on advanced colorectal cancer patients treated with hydroxycamptothecin plus leucovorin and 5-fluorouracil.Tumor,2004; 24(3):294-295.陳鴻,裘紅英.羥基喜樹堿聯合5-Fu/CF 治療晚期大腸癌臨床觀察.腫瘤,2004,24(3):294～295.
  18. 18. Sun Q,Zhao W,Mao YJ,et al.Clinical study on efficacy of HCPT combined with leucovorin,fluorouracil and oxaliplatin in treatment of 30 cases of advanced colorectal cancers.Chinese Journal of Clinical Oncology Rehabilitation,2004; 11(2):171-173.孫清,趙偉,毛永杰等.OLF方案聯合羥基喜樹堿治療30例晚期大腸癌療效觀察.中國腫瘤臨床與康復,2004; 11(2):171～173.
  19. 19. Yu PG,Xu DF,Qiu HM,et al.A comparison study on HLFP regimen and VLFP regimen in the treatment of advanced colorectal cancer.Journal of Oncology,2005; 11(4):275-276.余培根,許德鳳,邱慧敏等.HLFP與VLFP方案治療晚期大腸癌的臨床研究.腫瘤學雜志,2005; 11(4):275～276.
  20. 20. Xu XQ,Xiao JP,Zhang L,et al.Clinical observation of treating gastro enteric carcinoma with the combinated chemotherapy with hydroxycamptothecin.Lishizhen Medicine and Material Medical Research,2005; 16(9):899-900.徐新前,肖繼平,張莉等.含羥基喜樹堿聯合化療方案治療晚期胃腸道癌臨床觀察.時珍國醫(yī)國藥,2005; 16(9):899～900.
  21. 21. He ZM,Qing SK,Wang L,et al.The clinical study of HELF combined chemotherapy treatment in advanced gastric cancer.China Journal of Cancer Prevention and Treatment,2000; 27(3):220-225.何澤明,秦叔逵,王琳等.HELF聯合化療治療晚期胃癌臨床研究.腫瘤防治研究雜志,2000; 27(3):220～225.
  22. 22. Liu X,San BJ.Efficacy of hydroxycamptothecin based combination chemotherapy in advanced gastric cancer.Journal of Practical Oncology,2001; 15(3):212-213.柳星,傘寶君.以HCPT為主聯合化療治療晚期胃癌德臨床觀察.實用腫瘤學雜志,2001; 15(3):212～213.
  23. 23. Wei KJ.Clinical observation on HCPT + 5-Fu + CF in the treatment of 87 cases of gastrointestinal cancer.Journal of Fujian College of TCM,2004; 14(6):18.魏開建.羥基喜樹堿聯合亞葉酸鈣與5-氟脲嘧啶治療消化道腫瘤87例.福建中醫(yī)學院學報,2004; 14(6):18.
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