化疗联合热疗治疗晚期大肠癌疗效及安全性的Meta分析  

Chemotherapy Combined with Hyperthermia for Advanced Colorectal Cancer: A Meta-Analysis

作　　者：颉宝平[1,2] 李征[1,2] 姚南[1] 何智余[2] 

机构地区：[1]兰州大学第一医院普外科,兰州730000 [2]兰州大学第一临床医学院,兰州730000

出　　处：《中国循证医学杂志》2013年第3期352-357,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价化疗联合热疗(热化)与单纯化疗(单化)比较治疗晚期大肠癌的疗效和安全性。方法计算机检索CNKI、VIP、WanFang Data、CBM、EMbase、PubMed和e Cochrane Library(2012年第3期)等数据库,查找有关化疗联合热疗与单纯化疗比较治疗晚期大肠癌的随机对照试验(RCT),检索时限均为建库至2012年6月。由2位研究者按照纳入与排除标准独立筛选文献、提取资料并评价质量后,采用RevMan 5.1软件进行Meta分析。结果最终纳入11个RCT,共708例晚期大肠癌患者。Meta分析结果显示:在疗效方面,热化组的部分缓解率[OR=1.65,95%CI(1.39,1.97),P<0.000 01]及总有效率[OR=3.59,95%CI(2.51,5.12),P<0.000 01]均高于单化组,其差异均有统计学意义;在安全性方面,热化组的周围神经毒性并发症发生率低于单化组,其差异有统计学意义[OR=0.50,95%CI(0.33,0.75),P=0.000 8]。结论与单纯化疗相比,化疗联合热疗治疗晚期大肠癌可明显提高部分缓解率及总有效率,并可降低化疗相关的周围神经毒性并发症发生率。受纳入研究质量和数量所限,上述结论尚需开展更多高质量研究,特别是大样本、多中心的随机双盲对照试验来加以验证。推荐结合患者具体情况进行临床应用。Objective To assess the effectiveness and safety of hyperthermia combined with chemotherapy for ad- vanced colorectal cancer. Methods Databases such as CNKI, VIP, WanFang Data, CBM, EMbase, PubMed and The Cochrane Library （Issue 3, 2012） were electronically searched from the date of their establishment to June, 2012, and the relevant literature and conference proceedings were also manually searched to include randomized controlled trials （RCTs） on comparison of chemotherapy with hyperthermia plus chemotherapy for advanced colorectal cancer. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then the meta-analysis was performed by using RevMan 5.1 software. Results A total of 11 RCTs involving 708 patients with advanced colorectal cancer were included. The results of meta-analysis showed that： a） as for effectiveness, the chemotherapy combined with hyperthermia group was superior to the chemotherapy group in the partial improve rate （OR=1.65, 95%CI 1.39 to 1.97, P〈0.000 01） and the total effective rate （OR=3.59, 95%CI 2.51 to 5.12, P〈0.000 01）, with significant differences; b） as for safety, the chemotherapy combined with hyperthermia group was lower than the chemotherapy group in the incidence of neurotoxicity （OR=0.50, 95%CI 0.33 to 0.75, P=0.000 8）. Condusion Compared with chemotherapy, chemotherapy combined with hyperthermia can increase partial improve rate and total effective rate and reduce the incidence of neurotoxicity. Due to the limitation of the included studies, large sample size, multicenter, high quality studies are needed to verify the above conclusion. We recommend that chemotherapy combined with hyperthermia therapy could be applied to clinic combining individual conditions of patients.

关 键 词：大肠癌 结肠癌 直肠癌 化疗 热疗 系统评价 META分析 随机对照试验 

分 类 号：R735.3[医药卫生—肿瘤]