大分割同期放化疗对局限期SCLC临床价值的Meta分析  

Clinical value of Hypofractionated conformal radiotherapy in combination with chemotherapy for limited disease small-cell lung cancer: A Meta analysis

作　　者：杨海霞[1] 邵秋菊[1] 齐宇红[1] 王启明[1] 梁军[1] Yang Haixia;Shao Qiuju;Qi Yuhong;Wang Qiming;Liang Jun(Tangdu Hospital,Fourth Military Medical University,Shaanxi Xi'an 710038,China)

机构地区：[1]第四军医大学唐都医院,陕西西安710038

出　　处：《现代肿瘤医学》2019年第4期598-603,共6页Journal of Modern Oncology

摘　　要：目的:应用Meta分析评估大分割同期放化疗在局限期小细胞肺癌(limited disease small-cell lungcancer,LD-SCLC)中的价值。方法:检索中国生物医学文献数据库、中国学术期刊全文数据库、Cochrane Li-brary、Pub Med、Medline、Web of science、Embase国内外数据库有关局部局限期SCLC患者大分割同期放化疗与常规分割/超分割同期放化疗对比的文献,依据入选和排除标准收集各项研究的近期疗效及生存情况,应用Meta分析方法评价大分割同期放化疗的临床疗效。结果:纳入符合标准的国内外文献5篇,共包括837例患者。大分割放疗与常规或超分割放疗相比,无进展生存时间相似(P=0. 95);大分割放疗可延长局限期小细胞肺癌患者的总生存期(P=0. 03);同时,大分割放疗不增加急性放射性食管炎和肺炎的发生率(RR=0. 95,95%CI:0. 63～1. 42,P=0. 79; RR=0. 77,95%CI:0. 39～1. 51,P=0. 44)。结论:大分割较常规分割/超分割同步放化疗延长总生存时间,不增加毒性,可作为局限期小细胞肺癌治疗的选择模式。Objective: To investigate the clinical effect of Hypofractionated thoracic radiotherapy (HypoTRT) with concurrent chemotherapy for limited disease small-cell lung cancer(LD-SCLC) through a Meta analysis. Methods: CBM,CNKI,Cochrane Library,PubMed,Medline,Web of science and Embase were searched for the articles on comparison between HypoTRT with concurrent chemotherapy and Hyper-or conventionally fractionated thoracic radiotherapy(Hyper/Conv TRT) with concurrent chemotherapy in patients with LD-SCLC.According to the inclusion and exclusion criteria,the data on short-term outcome and survival were collected.A Meta analysis was performed to evaluate the clinical effect of HypoTRT in combination with chemotherapy for LD-SCLC. Results: A total of 5 articles were included,which involved 837 patients.The results showed that the progression-free survival were similar between patients receiving HypoTRT with concurrent chemotherapy and those receiving Hyper-or conventionally fractionated radiotherapy( P =0.95),but the patients receiving Hypofractionated concurrent radiochemotherapy showed a significantly longer overall survival than those receiving Hyper/Conv TRT( P =0.03).No significant differences in acute esophagitis and pneumonitis were demonstrated between the TRT cohorts(RR=0.86,95%CI:0.58~1.27, P =0.45;RR=0.77,95%CI:0.39~1.51, P =0.44). Conclusion: HypoTRT with concurrent chemotherapy shows significant advantages over Hyper/Conv TRT in overall survival without extra acute toxicities,suggesting that HypoTRT can be alternative for LD-SCLC patients.

关 键 词：局限期小细胞肺癌 大分割同期放化疗 常规分割/超分割 META分析 

分 类 号：R734.2[医药卫生—肿瘤]