ABSTRACT
OBJECTIVE： To systematically evaluate the efficacy and safety of thalidomide combined with conventional chemotherapy in the treatment of advanced gastric cancer， and to provide evidence-based reference for clinical drug use. METHODS： Retrieved from PubMed， Embase， Cochrane library， CNKI， Wanfang database and VIP， RCTs about thalidomide combined with conventional chemotherapy （observation group） vs. conventional chemotherapy （control group） in the treatment of advanced gastric cancer were collected. After data extraction and quality evaluation of included literatures with Cochrane system evaluator manual 5.0 risk evaluation tool， Meta-analysis was conducted by using Rev Man 5.3 statistical software. The evidence qualities of outcome indexes were evaluated by using Grade evidence quality classification system. RESULTS： A total of 13 studies were included， involving 761 patients. Results of Meta-analysis showed that the total response rate [OR＝1.72， 95％CI（1.29，2.31），P＝0.000 2]， complete remission rate [OR＝1.90，95％CI（1.05，3.44），P＝0.03]， disease control rate [OR＝2.66， 95％CI（1.92，3.68），P＜0.001]， improvement rate of survival quality [OR＝3.09， 95％CI（1.82，5.24），P＜0.001] and the incidence of constipation [OR＝2.64， 95％CI（1.74，4.01），P＜0.001] of observation group were significantly higher than those of control group， while disease progression rate [OR＝0.39， 95％CI （0.28，0.54）， P＜0.001] and the incidence of nausea and vomiting [OR＝0.32， 95％CI（0.18，0.56）， P＜0.001] of observation group were significantly lower than those of control group. Results of quality evaluation of Grade evidence showed that total response rate， complete remission rate， the incidence of leucopenia， thrombocytopenia， hemoglobin reduction and liver dysfunction were recommended for advanced evidence. Disease control was recommended for moderate-level evidence. The incidence of disease progression， peripheral neuritis， nausea and vomiting， diarrhea， constipation and hand-foot syndrome were recommended for low-level evidence. Improvement rate of survival was recommended for very low-level evidence. CONCLUSIONS： Thalidomide combined with conventional chemotherapy show significant therapeutic efficacy for advanced gastric cancer， can improve the quality of life but increase the risk of constipation.
ABSTRACT
In recent years,with the rapid development of minimally invasive surgery,some scholars have advocated laparoscopic surgery as a standard surgical procedure.Because of the physiological position of rectum and the limitations of pelvic space,the robot's fine operation and other advantages are very suitable for radical rectal cancer surgery.Although robot-assisted rectal cancer surgery is highly regarded by many scholars,there are still a few medical centers with Da Vinci robots at home and abroad.At this stage,the research on Da Vinci robotic surgery for rectal cancer is still in the exploratory stage.This article reviews the latest progress of Da Vinci robotic-assisted rectal cancer surgery.