化疗联合热疗治疗食管癌的Meta分析  

Meta-analysis of chemotherapy combined with thermotherapy for esophageal carcinoma

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

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》2013年第1期61-66,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：甘肃省卫生行业科研计划(GSWST09-06);甘肃省自然科学研究基金(1010RJZA162);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:评价化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Co-chrane Library、PubMed、EMBASE、Web of Science以及中国生物医学文献数据库、中国学术期刊全文数据库、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,检索时限为各数据库建库起至2012-08-01,收集所有比较化疗联合热疗与单纯化疗的随机对照试验(RCTs)。2位评价员按照研究计划书进行文献筛选和资料提取,并对纳入文献进行质量评价后,使用RevMan 5.1软件进行Meta分析。结果:共纳入11篇RCT,共641例患者。Meta分析结果显示,热化组的有效率和生活质量改善率均明显高于单纯化疗组,其OR值(95%CI)分别为2.64(1.90～3.66)和3.87(2.01～7.42),差异均有统计学意义,P<0.05;热化组白细胞减少、胃肠道反应、肾功损害、肝功损害及脱发反应的发生率均低于单化组,但只有白细胞减少、胃肠道反应及肾功损害发生率的差异有统计学意义,其OR值(95%CI)分别为0.59(0.37～0.94)、0.44(0.28～0.71)和0.44(0.20～0.94)。结论:相较于单纯化疗,化疗联合热疗能提高食管癌患者近期疗效,改善患者生活质量,并且能协同化疗进而降低其毒副作用,但其远期疗效和安全性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 combined with chemotherapy （TCT） for esophageal carcinoma, and provide the reference for clinical practice and research. METHODS： Foreign databases as Cochrane Library, PubMed, EMBASE, Web of Science and Chinese ones as CBM, CNKI, VIP and Wanfang were searched with computer and also retrieved other sources as supplying, such as tracing related references. All relevant randomized controlled trials （RCTs） were collected to compare TCT and chemotherapy alone. After literature screening,data extraction and quality evaluation independently conducted by two authors according to the protocal, the meta-analyses were performed using the RevMan 5.1 software. RESULTS： Eleven RCTs were involved with 641 patients included. Meta-analysis showed：Comparing TCT with pure chemotherapy,there were significant difference on the indicators of total effective rate and improvement rate of life quality,the OR（95%CI） were 2.64（1.90-3.66） and 3.87（2.01-7.42） respectively （P〈0.05）. The incidences of TCT were lower than those of pure chemotherapy on the indicators of leukocytopenia, alimentary canal reactions, renal lesion,hepatic lesion and alopecia, but there was statistically significant only on the indicators of leukocytopenia,alimentary canal reactions and renal lesion,the OR（95%CI） were 0. 59（0. 37-0. 94） ,0.44（0.28-0.71） and 0. 44（0. 20--0. 94） respectively. CONCLUSIONS： Compared with the chemotherapy alone, TCT can improve short-term curative effect, the quality of life, and the safety of clinical chemotherapy. The long-term survival rate and more comprehensive safety still need to be further verified by more large sample and high quality RCTs.

关 键 词：食管肿瘤 热疗 化疗 META分析 系统评价 随机对照试验 

分 类 号：R735.1[医药卫生—肿瘤]