目的评价替吉奥联合奥沙利铂(SOX)-线治疗转移性结直肠癌(mCRC)的有效性和安全性.方法通过 The Cochrane Library、PubMed、EMBASE和MEDLINE、中国知网(CNKI)、万方数据库等检索SOX方案一线治疗mCRC的多中心随机对照试验(RCT),用Rev Man 5.3版软件进行Meta分析.结果共纳入5项临床多中心RCT,合计例mCRC患者.Meta分析结果显示,与奥沙利铂联合其他氟尿嘧啶类化疗药物比较,SOX方案在无进展生存期(HR=0.90,95％CI:0.80～1.02,P=0.10)、总生存期(HR=1.14,95％CI:0.98～1.31 ,P=0.08)、客观缓解率(RR=1.12,95％CI:0.87～1.43,P = 0.38)、疾病控制率(RR=1.04,95％CI:0.98～1. 10,P=0.24)的差异均无统计学意义.3～4级不良反应:SOX方案组的白细胞减少发生率低于奥沙利铂联合其他氟尿嘧啶类药物(P<0.05),而口腔黏膜反应、厌食、腹泻的发生率高于奥沙利铂联合其他氟尿嘧啶类药物(P<0.05),两种方案在中性粒细胞减少、血小板减少、贫血、恶心、呕吐、乏力不良反应的发生率方面差异均无统计学意义(P>0.05).结论SOX一线治疗晚期结直肠癌的疗效与奥沙利铂联合其他氟尿嘧啶类药物的疗效相似,不良反应不同,替吉奥有可能成为除卡培他滨外口服氟尿嘧啶类一线治疗晚期结直肠癌的另一种选择.%Objective To investigate the efficacy and safety of S-l combined with oxaliplatin as first-line treatment for metastatic colorectal cancer (mCRC). Methods A wide search of randomized clinical trials (RCT) using S-l combined with oxaliplatin as a first-line therapy for mCRC patients was performed in the Cochrane Library, PubMed, EMBASE, MEDLINE, CNKI and WanFang databases. All included studies were assessed according to the guidance of the Cochrane Collaboration's tool for assessing risk of bias of RCTs, and then statistical analyses were performed using Rev Man 5.3 software. Results A total of 5 RCTs involving 1382 patients were included. Meta analysis indicated that the progression-free survival(HR = 0.90,95％CI:0.80-1.02, P = 0.10),overall survival(HR= 1.14, 95％CI:0.98-1.31, P=0.08), objective response rate(RR = 1.12,95％CI:0.87-1.43,P = 0.38) , disease control rate(RR= 1.04,95％CI:0.98-1.10,P= 0.24) , showed no statistical significance between S-l combined with oxaliplatin and oxaliplatin combined with 5-FU or capecitabine. For side effects, S-l combined with oxaliplatin could decrease incidence of grade 3-4 leukopenia, but increased the incidence of grade 3-4 stomatitis, anorexia, diarrhea. There were no statistical difference between the two regimen in the incidence of neutropenia, anemia, thrombocytopenia, nausea, vomiting and fatigue. Conclusion S-l combined with oxaliplatin seem to have similar efficacy in the first-line treatment for mCRC with different toxicity. The S-l may offer an alternative to 5-FU.
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