同步与序贯放化疗治疗食管癌的Meta分析  

Meta-analysis of concurrent versus sequential radiochemotherapy for esophageal cancer in chinese population

作　　者：邱恩毅[1,2] 赵喜悦[3] 沈洁[1,2] 张筱骅[4] 

机构地区：[1]温州医科大学定理临床学院 [2]温州市中心医院放疗科,浙江温州325000 [3]温州医科大学附属第一医院麻醉科,浙江温州325000 [4]温州医科大学附属第一医院肿瘤科,浙江温州325000

出　　处：《温州医学院学报》2013年第8期519-525,共7页Journal of Wenzhou Medical College

摘　　要：目的:分析同步放化疗与序贯放化疗在治疗食管癌的疗效和3～4级的不良反应。方法:检索国内有关数据库,查找15年内符合条件的临床随机对照试验。对国内公开发表的有关同步与序贯放化疗治疗食管癌的临床随机对照试验研究的文献采用Meta分析方法进行分析。在RevMan4.2.2软件中对相应的研究指标进行统计分析,应用Stata11.2软件进行发表偏倚检测。结果:有9项独立的临床随机对照试验研究进入了本次Meta分析。同步组在近期有效率(P<0.001)和3年生存率上优于序贯组(P=0.0001)。但同步组在3～4级放射性食管炎方面明显加重(P=0.02)。在其他3～4级的不良反应方面似有所增加,但差异无统计学意义(P>0.05)。Egger’s检验表明未有显著性发表偏倚。结论:同步放化疗确实较序贯放化疗在有效率、3年生存率、远处转移率方面更有优势。但3～4级不良反应的增加,尤其在放射性食管炎方面,应引起临床医师的注意。远期疗效和不良反应有待进一步观察随访和研究。Objective： To evaluate the objective responsiveness, survival and toxicities of concurrent chemoradiao therapy （cCRT） vs sequential chemoradiao therapy （sCRT） in patients with esophageal cancer. Methods： We searched the relevant quindecennial data from domestic database meeting the conditions of the clinical randomized controlled trials. We used Meta-analysis method to analysis the domestic published literatures about cCRT vs sCRT of esophageal cancer clinical randomized controlled trials. RevMan4.2.2 statistical analysis software analysised corresponding research index. Statal 1.2 software was used for publication biases in the study. Result： Nine separate clinical randomized controlled trials including 692 cases were researched into the Meta- analysis. The overall response （CR＋PR） rate （P 〈 0.001） and 3-year survival rates （P=0.0001） of cCRT group were superior to sCRT group. The grade 3 - 4 toxic effects in esophagus were more severe in the cCRT group than in the sCRT group （P=0.02）, but the grade 3 - 4 aspects of toxic effects in other aspects were no statistically significant differences （P 〉 0.05）. Conclusion： The short-term response rate and survival rate of patients with esophageal cancer treated by cCRT is superior to sCRT. However, long-term results need further study which involves prolonged follow-up.

关 键 词：食管肿瘤 放疗 化疗 同步 序贯 META分析 

分 类 号：R735.11[医药卫生—肿瘤]