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Clinical effect of nanoparticle albumin-bound paclitaxel combined with gemcitabine in treatment of advanced pancreatic cancer: A meta-analysis
文章发布日期:2019年05月10日  来源:  作者:王芸, 张耕源, 罗长江, 等  点击次数:475次  下载次数:90次
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【Abstract】:ObjectiveTo investigate the clinical effect of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) combined with gemcitabine in the treatment of advanced pancreatic cancer, and to provide a basis for making better clinical decisions. MethodsCBM, CNKI, Wanfang Data, VIP, PubMed, Embase, Cochrane Library, and Web of Science were searched for Chinese and English articles published up to October 2018, with English keywords of “pancreatic cancer”, “gemcitabine”, “nab-paclitaxel”, and “abraxane” and Chinese keywords of “pancreatic cancer”, “gemcitabine”, and “nanoparticle albumin-bound paclitaxel” (in Chinese). Appropriate clinical trials were screened out according to the inclusion and exclusion criteria. Then, the data were extracted and quality assessment was performed. RevMan 5.3 software was used to perform the meta-analysis. ResultsA total of 10 clinical trials were included, with a total of 2908 patients. There were 1633 patients in the study group (treated with nab-paclitaxel combined with gemcitabine) and 1275 patients in the control group (treated with FOLFIRINOX). The results of the meta-analysis showed that compared with the control group, the study group had significantly lower incidence rates of drug side-effects such as fatigue (odds ratio [OR]=0.61, 95% confidence interval [CI]: 0.46-0.80, P=0.0005), diarrhea (OR=0.39, 95% CI: 0.29-0.54, P<0.001), nausea and vomiting (OR=0.46, 95% CI: 0.26-084, P=0.01), and grade 3-4 neutropenia (OR=0.61, 95% CI: 0.43-0.88, P=0.007), as well as a significantly lower rate of second-line treatment (OR=0.30, 95% CI: 0.14-0.63, P=0.001). There were no significant differences between the two groups in disease remission rate (OR=0.82, 95% CI: 0.45-1.51, P=0.53), disease control rate (OR=0.97, 95% CI: 0.48-1.97, P=093), 1-year survival rate (OR=0.80, 95% CI: 0.63-1.01, P=0.06), and incidence rate of complications after neoadjuvant chemotherapy (OR=1.84, 95% CI: 0.33-10.19, P=0.49). ConclusionNab-paclitaxel combined with gemcitabine can improve the clinical outcome of advanced pancreatic cancer without increasing drug adverse events, and therefore, it has good safety and efficacy in clinical practice.
【Key words】:pancreatic neoplasms; albumin-bound paclitaxel; antineoplastic combined chemotherapy protocols; Meta-analysis

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