三维适形放疗同步替吉奥治疗中国老年食管癌的荟萃分析  

A Meta-analysis of Concurrent 3-DCRT Plus S-1 in Treatment of Elderly Patients with Esophageal Cancer in Chinese Population

作　　者：邱恩毅[1,2] 赵喜越[3] 金璋[1,2] 吴剑[1,2] 翁欣然[1,2] 沈洁[1,2] 

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,浙江温州325000 [3]温州医科大学附属第一医院,浙江温州325000

出　　处：《肿瘤学杂志》2015年第10期819-827,共9页Journal of Chinese Oncology

摘　　要：[目的]分析替吉奥联合三维适形放疗与单纯三维适形放疗治疗我国老年食管癌的疗效和不良反应。[方法]在万方、中国期刊网、维普、Pub Med、Medline、Cochrane Library等国内外有关数据库,查找符合条件的临床随机对照试验,检索时限为2005年1月至2014年1月,收集相关三维适形放疗联合替吉奥同步放化疗与单纯放疗治疗我国老年食管癌患者的临床随机对照试验。根据Cochrane系统评价手册5.0对纳入的研究进行质量评价。在Rev Man5.1软件中对相应的研究指标进行Meta分析。[结果 ]8个独立的随机对照试验,共540例患者,纳入Meta分析。同步组在近期有效率和1、2年生存率上均显著优于放疗组（P〈0.05）;其RR分别为1.39（95%CI：1.25～1.54）、1.35（95%CI：1.17～1.56）、1.61（95%CI：1.26～2.07）。在3年生存率方面有改善趋势,但无明显统计学差异（P〉0.05）。3～4级不良反应少见,大多可以耐受。在3～4级粒细胞减少方面同步组显著增多（P〈0.05）,RR为6.14（95%CI：1.63～23.12）。同步组较放疗组在3～4级消化道反应及急性放射性食管炎方面有增加趋势,但没有统计学意义。两组均没有3～4级放射性气管炎或肺炎的发生。漏斗图表明各项指标未有显著性发表偏倚。[结论]三维适形放疗同步替吉奥治疗我国老年食管癌患者,较单纯放疗在有效率和生存率方面均有显著提高,不良反应有所增加,但在可耐受范围。[Purpose ] To evaluate the efficacy and safety of concurrent three-dimensional confor- mal radiotherapy （3-DCRT） plus S-1 vs 3-DCRT in elderly patients with esophageal cancer in Chinese population. [Methods] We searched the relevant decade data（2005.1-2014.1） from domestic and foreign relevant databases （PubMed,Medline,Cochrane Library,Wanfang Data,Chinese Journal Database, VMIS）, meeting the conditions of the clinical randomized controlled trials, and evaluated the quality of each document according to the Cochrane Review＇s handbook 5.0.We used Meta- analysis method to analysis the published literatures about clinical randomized controlled trials, which were concurrent three-dimensional conformal radiotherapy plus S-1 in treatment of elderly patients with esophageal cancer.RevMan5.1 statistical analysis software was used to analyze corre- sponding research index. [Results ] Eight separate clinical randomized controlled trials including 540 cases were enrolled in the Meta-analysis. The overall response （CR＋PR） rates, 1-year overall survival rate and 2-year overall survival rate of cCRT group were superior to RT group（P〈0.05）.The RR values were 1.39 （95%CI： 1.25～1.54 ）, 1.35 （95%CI： 1.17～1.56）, 1.61 （95%CI： 1.26～2.07） respectively.But the 3-year overall survival rates were no statistically significant differences （P〉 0.05）.The grade 3～4 gastrointestinal adverse reactions were relatively rare and manageable.The grade 3～4 neutropenia were more severe in the cCRT group than that in the RT group （P〈0.05）, the RR was 6.14 （95%CI： 1.63～23.12）.But the grade 3-4 gastrointestinal adverse reactions and radiation esophagitis were no statistically significant differences （P〉0.05）.There were no grade 3～4 radiation bronchitis or pneumonitis in both groups.The funnel plot showed no significant publica- tion bias in each indexes. [Conclusions] The short-term response rates and survival rates of pa- tients with esophageal cancer treated by cCRT are s

关 键 词：食管肿瘤 老年 三维适形放疗 替吉奥 META分析 

分 类 号：R735.1[医药卫生—肿瘤]