关键词: 食管癌, 多西他赛, 顺铂, 5氟尿嘧啶, 有效性研究, meta分析

Abstract: Objective   To systematically review efficacy and safety of docetaxel,  cisplatin and 5fluorouracil in treatment of advanced esophageal cancer.Methods   PubMed,  Cochrane Library,  Web of Science,  Excerpta Medica Database (EMbase),  ChemicalBiological Munitions (CBM),  WanFang Data and Chinese National Knowledge Infrastructure (CNKI) were searched for the multicenter randomized controlled trials (mcRCTs) about docetaxel,  cisplatin and 5fluorouracil in treatment of advanced esophageal cancer from inception to December 2019. Results  A total of 4 mcRCTs involving 764 patients were included. The studies were of low bias according to the bias assessment tools. There were significant differences in ORR and OS between DCF group (in which esophageal cancer patients treated with docetaxel combine with cisplatin and 5fluorouracil) and control group(P=0.93,  I2=0<50%,  RR=1.58,  95%CI［1.281.94］,  P<0.01; P=0.86. I2=0<50%,  HR=1.16,  95%CI 1.051.29,  P=0.003). But, there were no significant differences in DCR (OR=1.23,  95%CI 0.742.05,  P=0.42). In terms of adverse events,  the incidence rates of thrombocytopenia (Level:14,  OR=2.15,  95%CI［1.044.46］, P=0.04; Level:34,  OR=9.64,  95%CI［9.1978.08］,  P=0.03),  diarrhea (Level:14,  OR=2.06,  95%CI［1.273.33］,  P=0.003; Level: 34,  OR=3.01,  95%CI［1.874.83］,  P<0.01),  mucositis (Level:14,  OR=4.21,  95%CI［2.566.92］, P<0.01; Level: 34,  OR=3.65,  95%CI［1.2210.90］,  P=0.02) in DCF group were higher than those in control group. There were no significant differences in leukocytopenia,  anaemia,  nausea and vomit between those two groups
(P>0.05).Conclusion  Docetaxel combine with cisplatin and 5fluorouracil showed no significant effects on the treatment of advanced esophageal cancer. And some adverse events such as thrombocytopenia,  diarrhea,  and mucositis were caused. The combined treatment must be applied with to patients with advanced esophageal cancer.

Key words: esophageal neoplasms, docetaxel, cisplatin, 5fluorouracil, validation studies, metaanalysis