根治性放疗与根治性手术治疗肌层浸润性膀胱癌的Meta分析  

A Meta-analysis of Radical Radiotherapy or Radical Cystectomy for Patients with Bladder Cancer Muscle Invaded

作　　者：龚虹云[1] 宋启斌[1] 胡伟国[1] 胡钦勇[1] 

机构地区：[1]武汉大学人民医院肿瘤中心,湖北武汉430060

出　　处：《中国肿瘤》2013年第8期671-675,共5页China Cancer

摘　　要：[目的]系统评价根治性放疗与根治性手术治疗膀胱癌临床效果。[方法]应用END-NOTE软件全面检索Pubmed(1973～2013年)数据库,对符合纳入标准的临床对照试验,采用RevMan4.3软件进行Meta分析。对于无对照临床研究资料,采用同质合并分析。[结果]共纳入6个临床对照试验,共1264例患者,Meta分析结果显示,根治性放疗与根治性手术切除治疗膀胱癌患者的5年生存率无统计学差异(P=0.36),合并比值比(OR)为1.10(95%CI:0.86～1.40)。18篇无对照临床研究共纳入根治性放疗治疗膀胱癌患者1749例,多数文献采用全膀胱放疗40～60Gy,联合以顺铂为基础的化疗方案,完全反应率达到65%以上,平均5年总生存率在50%以上,最低为37%,最高可达82%。[结论]根治性放疗不会降低膀胱癌患者生存率,且能维持正常膀胱功能,提高了患者生存质量。[Purpose] To investigate the response of radical cystectomy or radical radiotherapy for patients with bladder cancer muscle invaded. [Methods] The trails（randomized controlled trails and uncontrolled clinical trials） in Pubmed（1973～2013）were searched by ENDNOTE software. Meta-analysis was performed on the results of homogenous studies by RevMan 4.3.[Results] Six controlled clinical trials（1264 patients） were enrolled. The Meta-analysis results showed no statistical difference of 5-year survival between radical radiotherapy treatment group and radical surgery group （OR=1.10,95%CI： 0.86～1.40,P=0.36）. Eighteen clinical uncontrolled trials （1749 patients underwent by radical radiotherapy） were enrolled,most of the patients underwent radical radiotherapy（40～60Gy） and combined with cisplatin based chemotherapy. The complete response rate achieved 65%,the average 5-year survival was more than 50%（ 37%～82%）. [Conclusions] Radical radiotherapy will not reduce the survival rate in patients with bladder cancer muscle invaded. And it can maintain the normal bladder function and improve quality of life.

关 键 词：膀胱癌 根治性手术 根治性放疗 生存率 META分析 

分 类 号：R737.14[医药卫生—肿瘤]