Short-Term Efficacy and Safety of 10-Hydroxy-camptothecin Chemotherapy on Gastrointestinal Carcinoma: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Qi ¹ , GONG Fanjie ² , LI Yongguo ² , TAN ZeMing ³ , ZHOU Jianping ²

1. Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha 410078, China2. The 2nd Affiliated Xiangya Hospital, Central South University, Changsha 410011, China3. Xiangya Medical College, Central South University, Changsha 410078, China;

Corresponding author：

Keywords：

10-Hydroxy-camptothecin; Gastrointestinal carcinoma; Meta-analysis

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Objective　 To evaluate the short-term clinical efficacy and safety of 10-Hydroxy-camptothecin （10- HCPT ） chemotherapy on gastrointestinal carcinoma.
Methods 　We searched electronic database including CNKI （ 1995 - 2005 ）, MEDLINE （ 1995 - 2005 ） and The Cochrane Library （ Issue 1, 2005 ）. More related research data were odtained by cantacting with researchers. Randomized controlled trials of gastrointestinal carcinoma chemotherapy comparing only or including 10-HCPT chemotherapy with normal chemotherapy on efficacy rate, digestive and hematology system toxicity were included. Data related to the clinical outcome were extracted by two reviewers independently. Statistical analysis was performed by using RevMan4. 2.2.
Results 　Twenty-five trials including 1 881 patients met the inclusion criteria. The results of meta-analysis were hsted as follows： 10-HCPT could significantly improve the short-term chemotherapy efficacy for colorectal cancer （ RR. 1.62, 95% CI 1.37 to 1.92） and gastric cancer （RR 1.48, 95% CI 1.18 to 1.85）in chemotherapy curative efficacy in short-term. 10-HCPT induced severe toxicity of lower digestive system（RR. 0.96,95% CI 0.62 to 1.50 ） without statistical significance, while severe toxicity of hematology system was significantly higher than that of control with RR 1.27,95% CI 1.02 to 1.58.
Conclusions　 Current evidence suggests that 10-HCPT can improve hematology system short-term chemotherapy efficacy for gastrointestinal carcinoma and increase the incidence of severe toxicity. Further research is needed to value its influence on the prognosis of gastrointestinal carcinoma.

Citation： LIU Qi,GONG Fanjie,LI Yongguo,TAN ZeMing,ZHOU Jianping. Short-Term Efficacy and Safety of 10-Hydroxy-camptothecin Chemotherapy on Gastrointestinal Carcinoma: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2006, 06(2): 124-130. doi: Copy

1.	Cummings J,Smyth JE.DNA topoisomerase I and II as targets for rational design of new anticancer drugs.Ann Oncol;1993,4(7):533-543.
2.	Sun Y,Zhou JC.Manual medical oncology.The 3rd Edition.Peiking:People’s Medical Publishing House; 1996.24-34.孙燕,周际昌.主编.临床肿瘤内科手册.第3版.北京:人民卫生出版社,1996.24～34.
3.	Aldeson P,Green S,Higgins JPT editors.Cochrane Reviews’Handbook 4.2.2[Updated December 2003][M/CD].In:The Cochrane Library,Issue 1,2004.Chichester,UK:John Wiley ＆Sons,Ltd.
4.	He ZQ,Zhong MY,Cheng DY,et al.Clinical observation on effect of chemical therapy on patients with advanced colon cancer.Chinese Journal of Integrated Tradition-West Medical Digestion,2003; 11(2):98-99.何肇晴,钟敏钰,程冬英等.晚期大肠癌化疗的临床疗效观察.中国中西医结合消化杂志,2003; 11(2):98～99.
5.	Zhang L,Wang XD.A report of HCPT plus 5-Fu +CF versus 5-Fu + CF chemotherapy alone for advanced colorectal carcinoma.Henan Journal of Oncology,2001; 14(4):246-248.张力,王贤德.含羟基喜树碱方案联合化疗晚期大肠癌的临床观察.河南肿瘤学杂志,2001,14(4):246～248.
6.	Pan LX,Zhen XL,Huang FL,et al.Treatment of 93 cases with advanced colorectal carcinoma using a series of leucovorin plus 5-Fluorouracil regimens.China Oncology,1999; 9(3):221-223.潘良熹,郑秀立,黄富麟等.醛氢叶酸联合氟尿嘧啶系列方案治疗93例晚期结直肠癌.中国癌症杂志,1999; 9(3):221～223.
7.	Zhao WY.Efficacy of hydroxycamptothecin based combination chemotherapy in advanced colorectal cancer.Chinese Journal of Clinical Pharmacology and Therapy,1999; 4 (4):339-340.赵文英.含羟基喜树碱联合化疗方案治疗晚期大肠癌临床观察.中国临床药理学与治疗学,1999; 4(4):339～340.
8.	Xu WG,Hu MQ,Jiang GF.Efficacy of hydroxycamptothecin based combination chemotherapy in advanced gastrointestinal tract cancer.Chinese Journal of Clinical Oncology,2002; 29(9):625-632.徐伟刚,胡梅齐,姜观富.羟基喜树碱联合化疗治疗晚期胃肠道癌疗效观察.中国肿瘤临床,2002,29(9):625～632.
9.	Wu JQ,Pan LX,Feng JF,et al.Clinical observation of hydroxyl-camptothecin combination with 5-fluorouracil plus folinic acid on advanced colorectal cancer.Journal of QiLu Oncology,1997; 4(2):129-130.吴剑秋,潘良熹,冯继峰等.羟基喜树碱联合氟尿嘧啶及醛氢叶酸治疗晚期大肠癌临床观察.齐鲁肿瘤杂志,1997,4(2):129～130.
10.	Liu XM,Wang HQ,Cui XZ,et al.Preliminary study on HCPT combined with Leucovorin,5-Fu and cisplatin in the treatment of advanced colorectal cancer.Chinese Journal of Clinical Oncology,2001; 28(11):845-847.刘贤明,王华庆,崔秀珍等.羟基喜树碱联合DLF方案治疗晚期大肠癌.中国肿瘤临床,2001; 28(11):845～847.
11.	Liu J,Mao XH,Ling CR,et al.Comparative clinical study of HCPT verse DDP combined chemotherapy with advanced colorectal cancer.Journal of Practical Oncology,1998; 12(1):36-37.刘健,毛雪华,林传荣等.羟基喜树碱/顺铂联合方案治疗晚期大肠癌德随机性临床研究.实用肿瘤学杂志,1998; 12(1):36～37.
12.	Xu DL,Tu SP.Combined treatment of late colorectal cancer with the main HCPT.Chinese Journal of Gastroenterology and Hepatology,2001; 10(1):161-162.徐德亮,涂水平.以羟基喜树碱为主联合治疗晚期大肠癌.胃肠病学和肝病学杂志,2001; 10(1):161～162.
13.	Lu JZ,Ye YZ,Zhan Y,et al.Clinical study of advanced intestinal cancer treated by two different regimens.China Journal of Cancer Prevention and Treatment,2003; 10(11):1194-1195.卢介珍,叶勇智,詹颖等.两种化疗方案治疗晚期大肠癌的临床研究.肿瘤防治杂志,2003; 10(11):1194～1195.
14.	Xie DR,Peng WJ,Chen DJ,et al.Preliminary clinical study on HCPT combined with leucovorin and 5-Fu in treating patients with advanced colorectal carcinoma.Chinese Journal of Clinical Oncology,2001; 28(10):764-766.谢德荣,彭杰文,陈岱佳等.羟基喜树碱联用氟脲嘧啶/醛氢叶酸治疗晚期大肠癌的临床研究.中国肿瘤临床,2001,28(10):764～766.
15.	Ren XP,Wang XG,Zhu ZK,et al.Comparative study of curative effect of combination chemotherapy with hydroxycamptothecin in advanced digestive tract tumors.Chinese Journal of Clinical Oncology Rehabilitation,2003; 10(2):169-171.任晓萍,王兴国,朱增宽等.羟基喜树碱为主联合化疗治疗晚期消化道肿瘤疗效对照研究.中国肿瘤临床与康复,2003,10(2):169～171.
16.	Liu P.Clinical observation on HCPT + 5-Fu + CF in the treatment of 60 cases of colorectal cancer.Chinese Journal of Clinical Oncology Rehabilitation,2004; 11(4):313-314.刘萍.羟基喜树碱联合化疗方案治疗大肠癌60例临床观察.中国肿瘤临床与康复杂志,2004; 11(4):313～314.
17.	Chen H,Qiu HY.Clinical observation on advanced colorectal cancer patients treated with hydroxycamptothecin plus leucovorin and 5-fluorouracil.Tumor,2004; 24(3):294-295.陈鸿,裘红英.羟基喜树碱联合5-Fu/CF 治疗晚期大肠癌临床观察.肿瘤,2004,24(3):294～295.
18.	Sun Q,Zhao W,Mao YJ,et al.Clinical study on efficacy of HCPT combined with leucovorin,fluorouracil and oxaliplatin in treatment of 30 cases of advanced colorectal cancers.Chinese Journal of Clinical Oncology Rehabilitation,2004; 11(2):171-173.孙清,赵伟,毛永杰等.OLF方案联合羟基喜树碱治疗30例晚期大肠癌疗效观察.中国肿瘤临床与康复,2004; 11(2):171～173.
19.	Yu PG,Xu DF,Qiu HM,et al.A comparison study on HLFP regimen and VLFP regimen in the treatment of advanced colorectal cancer.Journal of Oncology,2005; 11(4):275-276.余培根,许德凤,邱慧敏等.HLFP与VLFP方案治疗晚期大肠癌的临床研究.肿瘤学杂志,2005; 11(4):275～276.
20.	Xu XQ,Xiao JP,Zhang L,et al.Clinical observation of treating gastro enteric carcinoma with the combinated chemotherapy with hydroxycamptothecin.Lishizhen Medicine and Material Medical Research,2005; 16(9):899-900.徐新前,肖继平,张莉等.含羟基喜树碱联合化疗方案治疗晚期胃肠道癌临床观察.时珍国医国药,2005; 16(9):899～900.
21.	He ZM,Qing SK,Wang L,et al.The clinical study of HELF combined chemotherapy treatment in advanced gastric cancer.China Journal of Cancer Prevention and Treatment,2000; 27(3):220-225.何泽明,秦叔逵,王琳等.HELF联合化疗治疗晚期胃癌临床研究.肿瘤防治研究杂志,2000; 27(3):220～225.
22.	Liu X,San BJ.Efficacy of hydroxycamptothecin based combination chemotherapy in advanced gastric cancer.Journal of Practical Oncology,2001; 15(3):212-213.柳星,伞宝君.以HCPT为主联合化疗治疗晚期胃癌德临床观察.实用肿瘤学杂志,2001; 15(3):212～213.
23.	Wei KJ.Clinical observation on HCPT + 5-Fu + CF in the treatment of 87 cases of gastrointestinal cancer.Journal of Fujian College of TCM,2004; 14(6):18.魏开建.羟基喜树碱联合亚叶酸钙与5-氟脲嘧啶治疗消化道肿瘤87例.福建中医学院学报,2004; 14(6):18.
24.	Guo ZL,Wang XJ.5-Fu continuing intravenous injection combined with CF/HCPT/DDP chemotherapy treatment advanced gastric cancer.Central Plains Medical Journal,2004; 31(14):5-6.郭忠良,王贤军.5-氟尿嘧啶持续静注联合亚叶酸钙、羟基喜树碱、顺铂治疗晚期胃癌.中原医刊,2004; 31(14):5～6.
25.	Liao GQ,Dai HF,Wang HM et al.The effect of HCPT treatment advanced gastroenteric tract tumors.BeiJing Medical Journal,2000,22(3):166-158.廖国清,戴海峰,王红梅等.羟基喜树碱治疗晚期胃肠道恶性肿瘤临床观察.北京医学,2000,22(3):166～158.
26.	Luan LW,Zhao ZF,Sun SJ,et al.Efficacy of hydroxycamptothecin plus 5-Fu +MMC chemotherapy in gastrointestinal tract cancer.Journal of Heilongjiang Medical,2003; 27(3):212-213.栾丽伟,赵志辅,孙淑娟等.羟基喜树碱5-氟脲嘧啶丝裂霉素联合治疗胃肠恶性肿瘤的疗效观察.黑龙江医学,2003; 27(3):212～213.
27.	Wu L,Ying XL,Zhou JT.The effect of HCPT combined chemotherapy treatment advanced gastro enteric tract tumors.Guangxi Medical Journal,2003; 25(5):698-701.邬麟,殷先利,周均田.以羟基喜树碱为主的联合化疗方案对晚期胃肠道肿瘤的疗效观察.广西医学,2003; 25(5):698～701.
28.	Liu L,Lu WN.HCPT combined regimen chemotherapy treat advanced gastric cancer.Henan Journal of Oncology,2004; 17(2):122-123.刘琳,卢文娜.加羟基喜树碱化疗方案治疗晚期胃癌疗效分析.河南肿瘤学杂志,2004; 17(2):122-123.
29.	Rowe PM.Camptothecins:new enthusiasm for an old drug.Lancet,1996; 347(9005):892.
30.	Bodley A,Liu LF,Israel M,et al.DNA topoisomerase II-mediated interaction of doxorubicin and daunorubicin congeners with DNA.Cancer Res,1989; 49(21):5969-5978.

1. Cummings J,Smyth JE.DNA topoisomerase I and II as targets for rational design of new anticancer drugs.Ann Oncol;1993,4(7):533-543.
2. Sun Y,Zhou JC.Manual medical oncology.The 3rd Edition.Peiking:People’s Medical Publishing House; 1996.24-34.孙燕,周际昌.主编.临床肿瘤内科手册.第3版.北京:人民卫生出版社,1996.24～34.
3. Aldeson P,Green S,Higgins JPT editors.Cochrane Reviews’Handbook 4.2.2[Updated December 2003][M/CD].In:The Cochrane Library,Issue 1,2004.Chichester,UK:John Wiley ＆Sons,Ltd.
4. He ZQ,Zhong MY,Cheng DY,et al.Clinical observation on effect of chemical therapy on patients with advanced colon cancer.Chinese Journal of Integrated Tradition-West Medical Digestion,2003; 11(2):98-99.何肇晴,钟敏钰,程冬英等.晚期大肠癌化疗的临床疗效观察.中国中西医结合消化杂志,2003; 11(2):98～99.
5. Zhang L,Wang XD.A report of HCPT plus 5-Fu +CF versus 5-Fu + CF chemotherapy alone for advanced colorectal carcinoma.Henan Journal of Oncology,2001; 14(4):246-248.张力,王贤德.含羟基喜树碱方案联合化疗晚期大肠癌的临床观察.河南肿瘤学杂志,2001,14(4):246～248.
6. Pan LX,Zhen XL,Huang FL,et al.Treatment of 93 cases with advanced colorectal carcinoma using a series of leucovorin plus 5-Fluorouracil regimens.China Oncology,1999; 9(3):221-223.潘良熹,郑秀立,黄富麟等.醛氢叶酸联合氟尿嘧啶系列方案治疗93例晚期结直肠癌.中国癌症杂志,1999; 9(3):221～223.
7. Zhao WY.Efficacy of hydroxycamptothecin based combination chemotherapy in advanced colorectal cancer.Chinese Journal of Clinical Pharmacology and Therapy,1999; 4 (4):339-340.赵文英.含羟基喜树碱联合化疗方案治疗晚期大肠癌临床观察.中国临床药理学与治疗学,1999; 4(4):339～340.
8. Xu WG,Hu MQ,Jiang GF.Efficacy of hydroxycamptothecin based combination chemotherapy in advanced gastrointestinal tract cancer.Chinese Journal of Clinical Oncology,2002; 29(9):625-632.徐伟刚,胡梅齐,姜观富.羟基喜树碱联合化疗治疗晚期胃肠道癌疗效观察.中国肿瘤临床,2002,29(9):625～632.
9. Wu JQ,Pan LX,Feng JF,et al.Clinical observation of hydroxyl-camptothecin combination with 5-fluorouracil plus folinic acid on advanced colorectal cancer.Journal of QiLu Oncology,1997; 4(2):129-130.吴剑秋,潘良熹,冯继峰等.羟基喜树碱联合氟尿嘧啶及醛氢叶酸治疗晚期大肠癌临床观察.齐鲁肿瘤杂志,1997,4(2):129～130.
10. Liu XM,Wang HQ,Cui XZ,et al.Preliminary study on HCPT combined with Leucovorin,5-Fu and cisplatin in the treatment of advanced colorectal cancer.Chinese Journal of Clinical Oncology,2001; 28(11):845-847.刘贤明,王华庆,崔秀珍等.羟基喜树碱联合DLF方案治疗晚期大肠癌.中国肿瘤临床,2001; 28(11):845～847.
11. Liu J,Mao XH,Ling CR,et al.Comparative clinical study of HCPT verse DDP combined chemotherapy with advanced colorectal cancer.Journal of Practical Oncology,1998; 12(1):36-37.刘健,毛雪华,林传荣等.羟基喜树碱/顺铂联合方案治疗晚期大肠癌德随机性临床研究.实用肿瘤学杂志,1998; 12(1):36～37.
12. Xu DL,Tu SP.Combined treatment of late colorectal cancer with the main HCPT.Chinese Journal of Gastroenterology and Hepatology,2001; 10(1):161-162.徐德亮,涂水平.以羟基喜树碱为主联合治疗晚期大肠癌.胃肠病学和肝病学杂志,2001; 10(1):161～162.
13. Lu JZ,Ye YZ,Zhan Y,et al.Clinical study of advanced intestinal cancer treated by two different regimens.China Journal of Cancer Prevention and Treatment,2003; 10(11):1194-1195.卢介珍,叶勇智,詹颖等.两种化疗方案治疗晚期大肠癌的临床研究.肿瘤防治杂志,2003; 10(11):1194～1195.
14. Xie DR,Peng WJ,Chen DJ,et al.Preliminary clinical study on HCPT combined with leucovorin and 5-Fu in treating patients with advanced colorectal carcinoma.Chinese Journal of Clinical Oncology,2001; 28(10):764-766.谢德荣,彭杰文,陈岱佳等.羟基喜树碱联用氟脲嘧啶/醛氢叶酸治疗晚期大肠癌的临床研究.中国肿瘤临床,2001,28(10):764～766.
15. Ren XP,Wang XG,Zhu ZK,et al.Comparative study of curative effect of combination chemotherapy with hydroxycamptothecin in advanced digestive tract tumors.Chinese Journal of Clinical Oncology Rehabilitation,2003; 10(2):169-171.任晓萍,王兴国,朱增宽等.羟基喜树碱为主联合化疗治疗晚期消化道肿瘤疗效对照研究.中国肿瘤临床与康复,2003,10(2):169～171.
16. Liu P.Clinical observation on HCPT + 5-Fu + CF in the treatment of 60 cases of colorectal cancer.Chinese Journal of Clinical Oncology Rehabilitation,2004; 11(4):313-314.刘萍.羟基喜树碱联合化疗方案治疗大肠癌60例临床观察.中国肿瘤临床与康复杂志,2004; 11(4):313～314.
17. Chen H,Qiu HY.Clinical observation on advanced colorectal cancer patients treated with hydroxycamptothecin plus leucovorin and 5-fluorouracil.Tumor,2004; 24(3):294-295.陈鸿,裘红英.羟基喜树碱联合5-Fu/CF 治疗晚期大肠癌临床观察.肿瘤,2004,24(3):294～295.
18. Sun Q,Zhao W,Mao YJ,et al.Clinical study on efficacy of HCPT combined with leucovorin,fluorouracil and oxaliplatin in treatment of 30 cases of advanced colorectal cancers.Chinese Journal of Clinical Oncology Rehabilitation,2004; 11(2):171-173.孙清,赵伟,毛永杰等.OLF方案联合羟基喜树碱治疗30例晚期大肠癌疗效观察.中国肿瘤临床与康复,2004; 11(2):171～173.
19. Yu PG,Xu DF,Qiu HM,et al.A comparison study on HLFP regimen and VLFP regimen in the treatment of advanced colorectal cancer.Journal of Oncology,2005; 11(4):275-276.余培根,许德凤,邱慧敏等.HLFP与VLFP方案治疗晚期大肠癌的临床研究.肿瘤学杂志,2005; 11(4):275～276.
20. Xu XQ,Xiao JP,Zhang L,et al.Clinical observation of treating gastro enteric carcinoma with the combinated chemotherapy with hydroxycamptothecin.Lishizhen Medicine and Material Medical Research,2005; 16(9):899-900.徐新前,肖继平,张莉等.含羟基喜树碱联合化疗方案治疗晚期胃肠道癌临床观察.时珍国医国药,2005; 16(9):899～900.
21. He ZM,Qing SK,Wang L,et al.The clinical study of HELF combined chemotherapy treatment in advanced gastric cancer.China Journal of Cancer Prevention and Treatment,2000; 27(3):220-225.何泽明,秦叔逵,王琳等.HELF联合化疗治疗晚期胃癌临床研究.肿瘤防治研究杂志,2000; 27(3):220～225.
22. Liu X,San BJ.Efficacy of hydroxycamptothecin based combination chemotherapy in advanced gastric cancer.Journal of Practical Oncology,2001; 15(3):212-213.柳星,伞宝君.以HCPT为主联合化疗治疗晚期胃癌德临床观察.实用肿瘤学杂志,2001; 15(3):212～213.
23. Wei KJ.Clinical observation on HCPT + 5-Fu + CF in the treatment of 87 cases of gastrointestinal cancer.Journal of Fujian College of TCM,2004; 14(6):18.魏开建.羟基喜树碱联合亚叶酸钙与5-氟脲嘧啶治疗消化道肿瘤87例.福建中医学院学报,2004; 14(6):18.
24. Guo ZL,Wang XJ.5-Fu continuing intravenous injection combined with CF/HCPT/DDP chemotherapy treatment advanced gastric cancer.Central Plains Medical Journal,2004; 31(14):5-6.郭忠良,王贤军.5-氟尿嘧啶持续静注联合亚叶酸钙、羟基喜树碱、顺铂治疗晚期胃癌.中原医刊,2004; 31(14):5～6.
25. Liao GQ,Dai HF,Wang HM et al.The effect of HCPT treatment advanced gastroenteric tract tumors.BeiJing Medical Journal,2000,22(3):166-158.廖国清,戴海峰,王红梅等.羟基喜树碱治疗晚期胃肠道恶性肿瘤临床观察.北京医学,2000,22(3):166～158.
26. Luan LW,Zhao ZF,Sun SJ,et al.Efficacy of hydroxycamptothecin plus 5-Fu +MMC chemotherapy in gastrointestinal tract cancer.Journal of Heilongjiang Medical,2003; 27(3):212-213.栾丽伟,赵志辅,孙淑娟等.羟基喜树碱5-氟脲嘧啶丝裂霉素联合治疗胃肠恶性肿瘤的疗效观察.黑龙江医学,2003; 27(3):212～213.
27. Wu L,Ying XL,Zhou JT.The effect of HCPT combined chemotherapy treatment advanced gastro enteric tract tumors.Guangxi Medical Journal,2003; 25(5):698-701.邬麟,殷先利,周均田.以羟基喜树碱为主的联合化疗方案对晚期胃肠道肿瘤的疗效观察.广西医学,2003; 25(5):698～701.
28. Liu L,Lu WN.HCPT combined regimen chemotherapy treat advanced gastric cancer.Henan Journal of Oncology,2004; 17(2):122-123.刘琳,卢文娜.加羟基喜树碱化疗方案治疗晚期胃癌疗效分析.河南肿瘤学杂志,2004; 17(2):122-123.
29. Rowe PM.Camptothecins:new enthusiasm for an old drug.Lancet,1996; 347(9005):892.
30. Bodley A,Liu LF,Israel M,et al.DNA topoisomerase II-mediated interaction of doxorubicin and daunorubicin congeners with DNA.Cancer Res,1989; 49(21):5969-5978.

Chinese Journal of Evidence-Based Medicine

Short-Term Efficacy and Safety of 10-Hydroxy-camptothecin Chemotherapy on Gastrointestinal Carcinoma: A Meta-analysis

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