新辅助动脉化疗治疗中晚期宫颈癌的疗效和安全性分析系统评价  

Neoadjuvant Intraarterial Chemotherapy in the Treatment of Advanced Cervical Cancer:A Systematic Review

作　　者：石文韬[1] 冯英[1] 蒋玙姝[1] 何倩雯[1] 魏蕾[1,2] 

机构地区：[1]武汉大学基础医学院病理学与病理生理学系,湖北武汉430071 [2]武汉大学医学结构生物学研究中心

出　　处：《中国循证医学杂志》2010年第4期463-470,共8页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价新辅助动脉化疗(neoadjuvant intraarterial chemotherapy,NIC)治疗中晚期宫颈癌的疗效和安全性。方法采用Cochrane系统评价方法,搜索PubMed、EMbase、Cochrane图书馆、VIP、CNKI、CBMdisc、会议论文、Ongoing Controlled Trial等数据库。检索从建库至2009年10月,NIC治疗中晚期宫颈癌的随机对照试验(RCT)和半随机对照试验(quasi-RCT),对符合纳入标准的临床研究进行质量评价和资料提取后,采用RevMan5.0进行Meta分析。结果共纳入15个研究,合计1331例患者。12个研究结果显示,NIC组的疗效是传统治疗组的6.72倍;多项研究结果发现,NIC组患者的一年以上生存率高于传统治疗组;同时,NIC组治疗的不良反应低于传统治疗组。结论本系统评价结果表明,NIC在疗效方面优于传统治疗方法,同时能够有效减少不良反应,为当前中晚期宫颈癌的临床治疗提供了一种新的辅助手段,在临床上有较好的应用前景。但是由于目前临床对于本病的治疗是多种放化疗方案并存的状况,因此,进行更高质量更有针对性的临床研究,提供NIC与各种传统放化疗方案相互对比的重要数据,是下一步需要深入研究的问题。Objective To assess the efficacy and safety of neoadjuvant intraarterial chemotherapy in the treatment of advanced cervical cancer. Methods We searched databases including PubMed, EMbase, The Cochrane Library, VIP, CNKI, CBMdisc, conference articles, and Ongoing Controlled Trial for Random Controlled Trials and quasi-Random Controlled Trials up to October 2009. For homogeneous studies, we performed meta-analysis. Results Fifteen studies involving 1 331 participants with advanced cervical cancer were included. Twelve studies showed that the efficacy of the NIC group was 6.72 times than that of the traditional group. Several studies showed that the survival rate of the NIC group was better than that of the traditional group. Meanwhile, the adverse events of the NIC group were fewer than those of the traditional group. Conclusions The results of this system review show that, NIC which is more effective than conventional treatments with less adverse reactions provides a new adjunct for clinical treatment of advanced cervical cancer . However, due to the current clinical treatment for the disease is the coexistence of multiple chemotherapy program status, the higher quality and more focused clinical research which will compare NIC with a variety of conventional chemotherapy are needed in the further.

关 键 词：中晚期宫颈癌 新辅助动脉化疗 系统评价 META分析 

分 类 号：R737.33[医药卫生—肿瘤]