不同化疗联合方案一线治疗转移性结直肠癌的网状Meta分析

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中图分类号 R979.1;R735.3;R730.5 文献标志码A 文章编号 1001-0408（2025）17-2197-08

DOI 10.6039/j.issn.1001-0408.2025.17.20

Network meta-analysis of first-line treatment of metastatic colorectal cancer with different chemotherapy combination regimens

ZHANG Xiaoqing'，LIU Shuai²， ZHANG Kai’，JI Beibei³，LUAN Wei³（1. Inner Mongolia Clinical Medical College，Inner Mongolia Medical University，Hohhot O100l7，China;2.Day-care Unit，Inner Mongolia Armed PoliceHospital，Hohhot O10041，China;3.Dept.of Medical Oncology，Inner Mongolia People’s Hospital， Hohhot 010017，China）

ABSTRACTOBJECTIVETosystematicall evaluatetheeficacyand safetyof diferentchemotherapycombinationregimens for first-linetreatmentofmetastaticcolorectalcancer（mCRC）.METHODsPubMed，CochraneLibrary，EmbaseandWebofScience wereelectronicallysarcedtocollectrandomizedcontrolledclinical tial（RCT）onfirst-linetreatmentformCRCfromJanuary1， 2000toFebruary16，2025.Tworeviewersindependentlyscreeedliterature，extracteddataandasessedtheriskofbiasof the includedstudies.Networkmeta-analysiswasperformedbyusingR4.4.3andStata17.0software.RESULTSAtotalof28RCTs， involving16interventionmeasures，wereincluded.Intermsofprolongingprogresion-freesurvival（PFS）andoverallsurvival （OS），FOLFOX（5-fluorouracil+oxaliplatin+calcium folinateregimen）+etuximabhadthehighest probabilityofranking first.In termsof improvingobjectiveresponserate（ORR），FOLFOXIRI（5-fluorouracil+oxaliplatin+iriotecan+calciumfolinateegimen） + bevacizumabandFOLFOX+bevacizumab+nivolumabhadthehighestprobabilityofrankingfirst；intermsoftheincidenceof grade 3orhigheradversereactions，FOLFOXIRI+panitumumabhadthehighestprobabilityofrankingfirst；insubgroupanalysisof KRAS wild-type patients，FOLFIRI（5-fluorouracil+irinotecan+calcium folinateregimen）+panitumumabandFOLFIRI+bevacizumab hadthe highest probabiltyofranking first interms of prolonging PFSandOS，respectively；intermsofORR，FOLFOXIRI+ cetuximabhadthehighestprobabiltyofranking first.CONCLUsIONS Infirst-inetreatmentformCRC，FOLFOXcombined withtargeted therapy hasadvantagesin termsof eficacy and safety. However， individualized treatmentstrategiesshouldbe formulated basedontheKRASgenestatusandtumorlocation of patients.

KEYWORDS colorectal cancers； network meta-analysis; randomized controlled trial；efficacy；safety

结直肠癌是全球范围内常见的恶性肿瘤之一，其全球发病率排第3位，死亡率排第2位;2020年世界卫生组织估算的全球新发结直肠癌患者超过193万人，死亡超过93万人。（剩余18848字）