新辅助化疗对进展期胃癌疗效的Meta分析  

Meta analysis on neoadjavunt chemotherapy in the treatment of advanced gastric carcinoma

作　　者：林苗[1] 

机构地区：[1]浙江省玉环县人民医院外科,317600

出　　处：《中国医师进修杂志》2012年第33期24-27,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价新辅助化疗治疗进展期胃癌的临床疗效。方法计算机检索CNKI、CBM、维普及PubMed数据库关于新辅助化疗治疗进展期胃癌的临床研究，根据纳入和排除标准选择文献，采用Jadad量表对纳入文献进行质量评价，应用Revman4．2软件对各评价指标进行Meta分析。结果共纳入16篇文献，研究对象1937例。新辅助化疗组根治性切除率和生存率高于传统手术组，而姑息性切除率低于传统手术组（根治性切除率：OR=1．900，95％CI1．30～2．77，P〈0．01；生存率：OR=1．83，95％CI1．43～2．33，P〈0．01；姑息性切除率：OR=0．54，95％C10．33—0．88，P=0．01），而两组术后病理分期比较差异无统计学意义（OR=1．03，95％C10．62～1．73，P=0．90）。结论现有临床证据显示新辅助化疗能提高进展期胃癌的根治性切除率及生存率。由于研究存在选择性偏倚和测量性偏倚的可能性，可影响结果的论证强度。故期待更多高质量的随机、双盲对照试验性研究，以提供更高质量的临床证据。Objective To review the effect of neoadjavunt chemotherapy on advanced gastric carcinoma. Methods The CNKI , CBM, VIP and PubMed online databases of clinical study about neoadjavunt chemotherapy in treatment of advanced gastric carcinoma were searched, according to inclusion and exclusion criteria for pooling of essay and Jadad scale was used. Revman software （version 4.2 ） was used to undertake Meta analysis for evaluating the overall effectiveness. Results Sixteen compared clinical study, 1937 patients in total had been included. The results showed that neoadjuvant chemotherapy group was higher than conventional surgery group on radical resection rate and survival rate （OR = 1.900,95% CI 1.30 - 2.77,P 〈 0.01 for radical resection rate, OR = 1.83,95% CI 1.43 - 2.33, P 〈 0.01 for survival rate ） and neoadjuvant chemotherapy group was lower than conventonal surgery group on palliation resection rate （OR = 0.54, 95% CI 0.33 -0.88, P = 0.01 ）. But there was no significant difference on pathological stage betwee two groups （OR = 1.03, 95% CI 0.62 - 1.73,P = 0.90）. Conclusions Existing clinical evidence suggest that neoadjuvant chemotherapy can improve the rate of radical resection and survival. But selection bias due to the existence of including studies and the possibility of measurement bias can affect the outcome of argument strength. So looking forward to more high-quality, randomized and double-blind controlled trial to provide higher quality evidence to guide the rationalization of clinical medicine is work in clinical search.

关 键 词：胃肿瘤 化学疗法 辅助 META分析 

分 类 号：R735.2[医药卫生—肿瘤]