脑转移瘤合理治疗模式的Meta分析  

Meta analysis of brain metastases ideal treatment mode

作　　者：李颖[1] 房晓萌[1] 姜达[1] 董倩[1] 张增叶[2] 郑飞[1] 

机构地区：[1]河北医科大学第四医院肿瘤内科,石家庄050011 [2]河北医科大学第三医院肿瘤内科

出　　处：《国际肿瘤学杂志》2015年第2期103-108,共6页Journal of International Oncology

基　　金：河北省卫生厅重点科技支撑计划（20110126）

摘　　要：目的应用Meta分析的方法探讨脑转移瘤的合理治疗模式。方法以中英文关键词检索中外数据库，检索时限为自各数据库建立起至2012年12月30日。以Jadad评分评价文献质量，采用RevMan5.0软件完成统计分析。共纳入25篇文献，2 750例患者，依据不同的治疗方法进行分组。结果与单一治疗相比，综合治疗能提高患者的1年生存率（OR=0.58，95%CI为0.46-0.71，P＜0.000 01）；在综合治疗组中，与2种联合治疗方式相比，3种联合治疗方式能提高患者的1年生存率（OR=0.63，95%CI为0.50-0.80，P=0.000 1）；与局部治疗相比，全身＋局部治疗能提高患者的1年生存率（OR=0.68，95%CI为0.53-0.86，P=0.001）；与全身治疗相比，全身＋局部治疗能提高患者的1年生存率（OR=0.59，95%CI为0.41-0.86，P=0.006）；在全身＋局部治疗中，与2种联合治疗方式相比，3种联合治疗方式能提高患者的1年生存率（OR=0.52，95%CI为0.35-0.78，P=0.002）；与非靶向治疗相比，分子靶向药物治疗能提高患者的1年生存率（OR=0.76，95%CI为0.67-0.87，P＜0.000 1）。结论脑转移瘤的合理治疗模式为手术、放疗、化疗3种治疗方式结合，即全身＋局部治疗，如果具有应用分子靶向药物的指征，在原方案基础上联合分子靶向药物效果更佳。ObjectiveTo explore the ideal treatment mode of brain metastases by Metaanalysis. MethodsArticles were searched for from the databases at home and abroad using English and Chinese keywords. Searching time limited from the databases setting up to December 30, 2012. Jadad score was applied to evaluate the qualities of literatures. RevMan5.0 software was applied to perform the Metaanalysis. A totle of 25 articles including 2 750 patients were eligible for the Metaanalysis, which divided into groups with different treatment. ResultsCompared with monotherapy, combined therapy improved 1year survival （OR=0.58, 95%CI： 0.46-0.71, P〈0.000 01）. In combined therapy groups, compared with two methods, three kinds of therapies improved 1year survival （OR=0.63, 95%CI： 0.50-0.80, P=0.000 1）. Compared with local therapy only or systemic therapy only, systemic combined local therapy improved 1year survival （OR=0.68, 95%CI： 0.53-0.86, P=0.001; OR=0.59, 95%CI： 0.41-0.86, P=0.006）. In systemic combined local therapy groups, three kinds of treatments improved 1year survival compared with two methods （OR=0.52, 95%CI： 0.35-0.78, P=0.002）. Compared with nonmolecular targeted therapy, molecular targeted therapy improved 1year survival （OR=0.76, 95%CI： 0.67-0.87, P〈0.000 1）. ConclusionThe reasonable treatment for patients with brain metastases is combined treatment with operation, radiotherapy and chemotherapy. There is better curative effect added molecular targeted therapy based on original scheme, if patients have targeted therapy indications.

关 键 词：META分析 肿瘤治疗方案 存活率 脑转移 

分 类 号：R739.41[医药卫生—肿瘤]