Meta-analysis of the efficacy between gemcitabine-alone and gemcitabine-based chemotherapy applied to advanced pancreatic cancer

/Song Kun

(宋堃，Dept Gen Surg，Xiangya Hosp Centr South Univ，Changsha 410008)…∥Chin JGen Surg.-2011，49(9).-839～842

ObjectiveTo compare the efficacy of gemcitabine(GEM)alone and gemcitabine based combination chemotherapy(GEMCOM)on advanced pancreatic cancer.MethodsKeywords PhaseⅢ，gemcitabine and pancreatic cancer were used to search and collect Phase Ⅲ-randomized references about gemcitabine and gemcitabinebased combination chemotherapy applied to advanced pancreatic cancer.A references-based meta-analysis was made to compare the efficacy between GEM and GEMCOM.Before that，test for heterogeneity was committed.Fixed effect model was used if the I2≤50% ，and random effect model was used if not.The evaluating indicators were overall response rate and 1-year survival rate.Results There were 14 randomized controlled trial(RCT)and 10 RCT enrolled in overall response rate analysis and 1-year survival rate analysis，respectively.Resultsof meta-analysis showed that，arm GEMCOM’s overall response rate and 1-year survival rate were higher than arm GEM’s(z=2.190，P=0.028 vs.z=4.400，P=0.000).The differences were significant.The biases of the results were tested by Egger-test.The tests showed that no bias exists in both of two meta-analysis(t=0.070，P=0.946 and t=-0.740，P=0.483)respectively.ConclusionThere is a possibility that the gemcitabine-combination is more effective than the gemcitabine on overall response rate and 1-year survival rate.19 refs，3 figs，1 tab