Meta-Analysis on Efficacy and Safety of Raltitrexed Combined with Irinotecan in the Second-Line Treatment of Advanced Colorectal Cancer
OBJECTIVE:To evaluate the efficacy and safety of raltitrexed combined with irinotecan regimen compared with 5-fluorouracil + calcium folinate + irinotecan(FOLFIRI)regimen in the second-line treatment of advanced colorectal cancer.METHODS:Clinical randomized controlled trials on raltitrexed combined with irinotecan regimen compared with FOLFIRI regimen in the second-line treatment of advanced colorectal cancer were collected by retrieving PubMed,Embase,the Cochrane Library,CNKI,SinoMed,Wanfang Data and VIP database from base-building to Jul.2023,literature screening,quality evaluation and data extraction were conducted according to the inclusion and exclusion criteria,Meta-analysis was performed by using RevMan 5.4 software and publication bias was analyzed by adopting Stata 13.1 MP software.RESULTS:A total of 7 studies were enrolled,including 449 patients.The raltitrexed combined with irinotecan group was higher than the FOLFIRI group in terms of objective remission rate(OR= 3.06,95%CI=1.96-4.80,P<0.000 01)and disease control rate(OR=2.19,95%CI=1.42-3.38,P=0.000 4),both with statistically significant differences.Among the grade Ⅰ to Ⅳ adverse drug reactions,the raltitrexed combined with irinotecan group was lower than the FOLFIRI group in terms of the incidence of neutropenia(OR=0.22,95%CI=0.05-0.89,P=0.03)and the incidence of mucositis(OR=0.30,95%CI=0.17-0.54,P<0.000 1),while the raltitrexed combined with irinotecan group was higher than the FOLFIRI group in terms of the incidence of liver function injury(OR=2.81,95%CI=1.45-5.43,P=0.002),with statistically significant differences.In terms of the incidences of the rest grade Ⅰ to Ⅳ adverse drug reactions and grade Ⅲ/Ⅳ adverse drug reactions,the differences were not statistically significant between two groups(P>0.05).CONCLUSIONS:The application of raltitrexed combined with irinotecan regimen in the second-line treatment of advanced colorectal cancer is higher than the FOLFIRI regimen in terms of objective remission rate and disease control rate,and is only higher than the FOLFIRI regimen in terms of the incidence of abnormal liver function in adverse drug reactions,the raltitrexed combined with irinotecan regimen is expected to become an ideal regimen for the second-line treatment of advanced colorectal cancer.
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