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目的:评价包含多西他赛的新辅助化疗方案在进展期胃癌治疗中的有效性和安全性。方法:计算机检索多个国内外数据库收集相关文献,按文献纳入与排除标准,筛选出符合要求的随机对照试验(RCT)文献,提取相关数据并进行文献质量评估,应用Rev Man 5.3软件进行Meta分析。结果:总共纳入10篇RCT文献,共计845例患者。Meta分析整体结果显示,试验组(含多西他赛的新辅助化疗联合手术)的R0切除率(OR=1.90,95%CI=1.28~2.81,P=0.001)及临床有效率(OR=1.92,95%CI=1.05~3.51,P=0.03)均高于对照组(单纯手术或不含多西他赛的新辅助化疗联合手术),而两组手术切除率(OR=1.59,95%CI=0.93~2.73,P=0.09)及术后并发症发生率(OR=1.01,95%CI=0.65~1.59,P=0.95)差异均无统计学意义;亚组分析结果显示,含多西他赛的新辅助化疗联合手术组与不含多西他赛的新辅助治疗联合手术组间R0切除率无统计学差异(P>0.05)。结论:含多西他赛的新辅助化疗方案在不增加术后并发症发生率的同时,可提高进展期胃癌根治性手术切除率及临床有效率,表现出较好的安全性和有效性。
Objective: To evaluate the efficacy and safety of neoadjuvant chemotherapy regimen containing docetaxel in the treatment of advanced gastric cancer. Methods: The computer searched a number of domestic and foreign databases to collect relevant documents, according to the inclusion and exclusion criteria of the documents, screened the qualified randomized controlled trials (RCT) literature, extracted relevant data and literature quality assessment, the use of Rev Man 5.3 software Meta analysis . Results: A total of 10 RCTs were included for a total of 845 patients. The meta-analysis of overall results showed that the R0 resection rate (OR = 1.90, 95% CI = 1.28-2.81, P = 0.001) and clinical efficacy (OR = 1.92 , 95% CI = 1.05-3.51, P = 0.03) were higher than those in the control group (neoadjuvant chemotherapy combined with surgery alone or without docetaxel), while the resection rate (OR = 1.59, 95% CI = 0.93 ~ 2.73, P = 0.09) and the incidence of postoperative complications (OR = 1.01,95% CI = 0.65-1.59, P = 0.95). There was no significant difference in subgroup analysis There was no significant difference in R0 resection rate between the neoadjuvant chemotherapy combined surgery group and the neoadjuvant therapy combined with surgery group (P> 0.05). Conclusions: Neoadjuvant chemotherapy with docetaxel can improve the radical resection rate and clinical efficiency of advanced gastric cancer without increasing the incidence of postoperative complications, and shows good safety and efficacy.