ABSTRACT
In recent years, the incidence of colon cancer has increased year by year, but the pathogenesis of colon cancer is still unclear. With the in-depth research on the cause of colon cancer, people have found that there's a close relationship between intestinal flora and the occurrence and development of colon cancer. According to the research results, clinical attempts have been made to use probiotics for colon cancer patients to regulate the intestinal flora, thereby assisting in the treatment of colon cancer, and these attempts have achieved certain results and are worthy of clinical promotion.
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.