SBRT对比手术治疗Ⅰ期可手术切除NSCLC系统评价  

Stereotactic body radiotherapy versus surgery for resectable stage Ⅰ non-small cell lung cancer：a systematic evaluation

作　　者：白鸽[1] 初建虎[3] 包永星[1] 玛依努尔·艾力[1] 郑超[1] 马乐[1] 张莉[2] 

机构地区：[1]新疆医科大学第一附属医院肿瘤中心,乌鲁木齐830011 [2]新疆医科大学第一附属医院内科VIP,乌鲁木齐830011 [3]新疆医科大学附属肿瘤医院胸外科,乌鲁木齐830011

出　　处：《中华放射肿瘤学杂志》2016年第7期690-693,共4页Chinese Journal of Radiation Oncology

摘　　要：目的 系统评价SBRT对Ⅰ期可手术切除NSCLC患者的有效性和安全性。方法 计算机检索Cochrane图书馆、MEDLINE、EMbase、中国生物医学文献数据库、中国期刊全文数据库和万方数据库,收集SBRT与手术治疗Ⅰ期可手术切除NSCLC的临床试验,由2名评价员按照纳入与排除标准选择文献、评价质量和提取资料,对符合纳入标准的研究用 RevMan 5.3软件进行 Meta分析。结果 共纳入4个临床试验,410例患者。Meta分析结果显示SBRT与手术治疗3年OS率差异无统计学意义（RR=1.13,95%CI为0.66~1.94,P=0.66）;两组LC率差异也无统计学意义（RR=0.71,95%CI为0.26~1.93,P=0.50）;两组3—4级不良反应差异有统计学意义（RR=0.29,95%CI为0.16~0.53,P=0.000）,SBRT组3—4级不良反应较手术组少。结论 SBRT已显示出其治疗Ⅰ期可手术切除NSCLC患者的手术等效性,但该系统评价存在一定局限性,尚需进一步大样本临床随机对照试验进行证明。Objective To systematically evaluate the efficacy and safety of stereotactic body radiotherapy （SBRT） for resectable stage Ⅰ non-small cell lung cancer （NSCLC）. Methods Clinical trials of SBRT or surgery for resectable stage Ⅰ NSCLC were collected by computerized search of Cochrane Library, MEDLINE, EMbase, CBM, CNKI, and VIP. Literature selection, quality evaluation, and data extraction were performed by two inspectors based on the inclusion and exclusion criteria. A meta-analysis was performed on the enrolled studies using RevMan 5.3 software. Results A total of four clinical trials involving 410 patients were included. The results of meta-analysis showed that there was no significant difference in 3-year overall survival rate between SBRT and surgery （RR=1.13, 95%CI=0.66-1.94, P=0.66）;there was no significant difference in local control rate between SBRT and surgery （RR=0.71, 95%CI=0.26-1.93, P=0.50）;patients treated with SBRT had significantly lower incidence rates of grade 3-4 adverse reactions than those treated with surgery （RR=0.29, 95%CI=0.16-0.53, P=0.000）. Conclusions SBRT shows equivalent efficacy to surgery in the treatment of resectable stage Ⅰ NSCLC. However, due to the limitations in this systematic evaluation, the conclusion needs to be further confirmed by large randomized controlled trials.

关 键 词：癌 非小细胞肺/立体定向放射疗法 癌 非小细胞肺/外科学 系统评价 

分 类 号：R734.2[医药卫生—肿瘤]