诱导化疗联合同步放化疗与单纯同步放化疗分别治疗局部晚期头颈部肿瘤的系统评价  

Meta-analysis on Induction Chemotherapy Combined with Concurrent Chemotherapy and Concurrent Chemoradiotherapy Alone in Treatment of Locally Advanced Head and Neck Cancer

作　　者：魏佳[1] 化怡纯 尚昆[1] 戴岩[1] 俞静[1] 

机构地区：[1]首都医科大学附属北京友谊医院肿瘤中心,北京100050

出　　处：《中国医院用药评价与分析》2017年第7期872-875,878,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金(No.81101737);北京市"215"高层次卫生人才资助项目(No.2014-3-004)

摘　　要：目的:系统评价诱导化疗(induction chemotherapy,IC)联合同步放化疗(concurrent chemoradiotherapy,CCRT)与单纯CCRT分别治疗局部晚期头颈部肿瘤的疗效与安全性。方法:计算机检索Pub Med、Embase、维普数据库、中国期刊全文数据库、万方资源数据库中相关文献,纳入符合标准的随机对照研究,采用Revman 5.0软件进行文献荟萃(Meta)分析。结果:共纳入8篇文献,共1376例头颈部肿瘤患者。Meta分析结果显示,疗效方面,IC+CCRT组与CCRT组患者的中位无进展生存期(HR=0.90,95%CI=0.75~1.09,P=0.27)、中位总生存期(HR=1.01,95%CI=0.82~1.24,P=0.95)、客观缓解率(OR=1.03,P=0.89)、疾病控制率(OR=1.12,P=0.63)的差异均无统计学意义。安全性方面,IC+CCRT组患者Ⅲ级及以上不良反应发生率明显高于CCRT组,差异有统计学意义(P<0.05)。结论:与单纯CCRT相比,IC联合CCRT在延长晚期头颈部恶性肿瘤患者的生存期和提高总缓解率方面均未显示出足够的优势,反而增加了Ⅲ级及以上不良反应的发生。OBJECTIVE： To systematically evaluate the efficacy and safety of induction chemotherapy（ IC）combined with concurrent chemotherapy（ CCRT） and CCRT alone in treatment of locally advanced head and neck cancer. METHODS： Relevant randomized controlled trials from Pubmed,Embase,VIP,CNKI,Wanfang data base were retrieved by computers,Rev Man 5. 0 software was adopted to conducted on Meta-analysis. RESULTS： Totally8 literatures were involved,including 1 376 cases of head and neck cancer patients. According to Meta-analysis,for efficacy,there was no statistically significant difference between IC ＋ CCRT group and CCRT group in median progression free survival（ HR = 0. 90,95% CI = 0. 75-1. 09,P = 0. 27）,median overall survival（ HR = 1. 01,95% CI = 0. 82-1. 24,P = 0. 95）,objective remission rate（ OR = 1. 03,P = 0. 89） and disease control rate（ OR = 1. 12,P = 0. 63）. In terms of safety,the incidence of adverse drug reactions in IC ＋ CCRT group was higher than that in CCRT group,with statistically significant difference（ P 〈0. 05）. CONCLUSIONS： Compared with CCRT alone,IC combined with CCRT shows sufficient advantages in prolong survival time and increase total remission rate of advanced head and neck cancer,and increases the incidence of adverse drug reactions of third-level or above.

关 键 词：头颈部肿瘤 诱导化疗 同步放化疗 META分析 

分 类 号：R979.1[医药卫生—药品]