放疗联合热疗治疗食管癌的Meta分析  

Radiotherapy plus thermotherapy for esophageal carcinoma:A Meta-analysis

作　　者：李征[1,2] 米登海[1,3] 杨克虎[1,2] 田金徽[1] 王道英[1,2] 

机构地区：[1]兰州大学循证医学中心,甘肃兰州730000 [2]兰州大学第一临床医学院普外科,甘肃兰州730000 [3]甘肃省第二人民医院肿瘤科,甘肃兰州730000

出　　处：《中华肿瘤防治杂志》2012年第9期671-675,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：甘肃省卫生行业科研计划项目(GSWST09-06);兰州大学循证医学中心循证医学研究生创新基金(2010LDEBM-A)

摘　　要：目的:评价放疗联合热疗治疗食管癌的疗效及安全性,为临床实践与研究提供参考。方法:计算机检索CochraneLibrary、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和数字化期刊全文数据库,同时辅以其他检索。收集所有比较放疗联合热疗与单纯放疗的随机对照试验(RCTs)。选择适合本研究特点的质量评价标准对纳入文献进行质量评价,使用RevMan 5.1软件进行Meta分析。结果:共纳入15篇RCT(1 279例患者)。放疗联合热疗组的1、2、3、5年生存率和1年局部控制率以及总有效率均明显高于单纯放疗组,差异有统计学意义,OR(95%CI)值分别为2.46(1.80～3.36)、1.99(1.14～3.50)、2.05(1.50～2.80)、1.82(1.21～2.75)、2.82(1.32～6.01)和4.33(2.62～7.14);放疗联合热疗组与单放组白细胞下降、胃肠道反应、放射性肺炎、放射性肺纤维化、放射性食管炎及放射性食管狭窄发生率的差异均无统计学意义,P>0.05。结论:相较于单纯放疗,放疗联合热疗能提高患者远期生存率和近期疗效,而且并不增加毒副反应。但其安全性评价结果尚需大样本高质量的RCT进一步验证。OBJECTIVE： To evaluate the clinical efficacy and safety of Thermotherapy plus Radiotherapy（TRT） for esophageal carcinoma, and to provide the reference for clinical practice and research. METHODS： We searched foreign databases as Cochrane Library,PubMed,EMBASE and Chinese ones as CBM,CNKI, VIP and Wanfang with computer and also retrieved other sources as supplying, such as tracing related references. All relevant randomized controlled trials （RCTs） were collected to compare TRT and radiotherapy alone. The quality of the included studies was assessed by adequate standard base on outcomes and the clinical instance. Meta-analysis was conducted by RevMan 5. 1 software. RE- SULTS：Fifteen RCTs were involved with 1 279 patients included. Meta-analysis showed：Comparing TRT with pure radiotherapy, there were significant difference on the indicators of 1,2,3,5-year survival rate, 1-year local control rate, total effective rate;the OR（95%CI）value were 2.46（1.80±3.36）,1.99 （1. 14±3.50）,2.05 （1.50±2.80）,1.82 （1.21± 2.75） ,2.82（1.32±6.01） ,and 4.33（2.62±7.14） respectively. There was no significant difference on the indicators of myelosuppression,alimentary canal reactions, radiation pneumonitis, radioactive pulmonary fibrosis, radiation esophagitis and radioactive esophageal strictures. CONCLUSIONS：Compared with the radiotherapy alone,TRT can improve long-term survival rate and short-term curative effect,and its safety can be accepted. Its more comprehensive security still needs to be further verified by more large sample and high quality RCTs.

关 键 词：食管肿瘤 放射治疗 高温 诱发 META分析 

分 类 号：R735.1[医药卫生—肿瘤]