新辅助化疗联合同期放化疗对中晚期鼻咽癌疗效及毒性的Meta分析  

The efficacy and toxicity of neoadjuvant chemotherapy followed by concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma:a Meta-analysis

作　　者：林建芳[1] 

机构地区：[1]宁德市医院放疗科,福建宁德352000

出　　处：《现代肿瘤医学》2013年第12期2695-2699,共5页Journal of Modern Oncology

摘　　要：目的:分析新辅助化疗+同期放化疗±辅助化疗(NCRT组)与同期放化疗±辅助化疗(CRT组)治疗中晚期鼻咽癌的疗效及毒副反应。方法:计算机检索PubMed、Cochrane图书馆、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库和万方数据库等,纳入新辅助化疗+同期放化疗±辅助化疗治疗中晚期鼻咽癌的临床随机对照试验(RCT),依据Jadad质量记分法进行质量评价,采用RevMan 4.2软件进行Meta分析。结果:最终纳入6个RCT(496例)。Meta分析结果显示,NCRT组较CRT组可进一步提高CR率及2、3年OS,但同时中重度毒副反应亦有所增加,白细胞减少及口腔黏膜炎NCRT组分别是CRT组的1.78、1.75倍。结论:新辅助化疗+同期放化疗±辅助化疗可在同期放化疗±辅助化疗基础上进一步提高中晚期鼻咽癌的疗效,但在毒副反应方面仍需进一步研究。Objective ：To evaluate the differences of efficacy and toxicity between neoadjuvant chemotherapy fol- lowed by concurrent chemoradiotherapy ＋ adjuvant chemotherapy and concurrent chemoradiotherapy ± adjuvant chemo- therapy for locally advanced nasopharyngeal carcinoma. Methods： Literatures were researched on database PubMed, Cochrane Library, Chinese Biomedical Literture Database, China Journal Full Text Database, Chinese Scientific Jour- nals Full Text Database and Wanfang Database. All the relevant randomized controlled trials that about neoadjuvant chemotherapy followed by concurrent chcmoradiotherapy ± adjuvant chemotherapy for locally advanced nasopharyngeal carcinoma were collected and the quality of the included trials was assessed by the Jadad quality scoring method. Metaanalyse was conducted by RevMan 4.2 software. Results： Six studies were involved and 496 patients were included. Meta analysis showed that NCRT can improve the complete remission rate and 2 and 3 years of survival rate, in con- trast to CRT. But at the same time, the incidence of severe toxic and adverse reaction is also increased. Leucopenia and oral mucositis in NCRT is 1.78,1.75 times in contrast to CRT. Conclusion：In contrast to concurrent chemora- diotherapy ± adjuvant chemotherapy, neoadjuvant chemotherapy followed by concurrent chemoradiotherapy ± adjuvant chemotherapy can improve the efficacy of locally advanced nasopharyngeal carcinoma, but the toxic and adverse reac- tion still needs to be studied further.

关 键 词：鼻咽癌 新辅助化疗 同期放化疗 随机对照试验 META分析 

分 类 号：R730.53[医药卫生—肿瘤] R730.55[医药卫生—临床医学]