早期高危宫颈癌患者术后同步放化疗和序贯放化疗的疗效和安全性  

Efficacy and safety of postoperative concurrent chemoradiotherapy and sequential chemoradiotherapy in high-risk early-stage cervical cancer

作　　者：陈变 杨健筌 CHEN Bian;YANG Jianquan(Department of Oncology,Yingshan People’s Hospital,Nanchong 637700,Sichuan,China;School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)

机构地区：[1]营山县人民医院肿瘤科,四川南充637700 [2]电子科技大学医学院,成都6100410

出　　处：《癌症进展》2021年第13期1374-1377,共4页Oncology Progress

摘　　要：目的应用Meta分析方法评价早期高危宫颈癌患者术后同步放化疗和序贯放化疗的疗效和安全性。方法通过计算机在PubMed、Embase、The Cochrane Library、CNKI、CBM、维普及万方数据库中检索相关文献,依据纳入和排除标准筛选关于早期高危宫颈癌患者术后同步放化疗和序贯放化疗的随机对照研究,对符合标准的文献进行方法学质量评价,采用RevMan 5.3版软件进行Meta分析。结果共纳入8篇文献,包括1382例早期高危宫颈癌患者。Meta分析结果显示,与术后序贯放化疗相比,术后同步放化疗能够明显提高早期高危宫颈癌患者的3年生存率(OR=3.95,95%CI:2.11~7.39,P﹤0.01),但未能提高患者的5年生存率(OR=0.97,95%CI:0.68~1.39,P=0.89)。虽然术后同步放化疗和术后序贯放化疗患者的3~4级骨髓抑制发生率比较,差异无统计学意义(OR=1.21,95%CI:0.91~1.63,P=0.20),但术后同步放化疗增加了3~4级胃肠道反应的发生率(OR=2.26,95%CI:1.63~3.14,P﹤0.01)。结论现有研究表明,与术后序贯放化疗相比,术后同步放化疗未能提高早期高危宫颈癌患者的5年生存率,同时增加了3~4级胃肠道反应的发生率。Objective To systematically evaluate the efficacy and safety of postoperative concurrent chemoradiotherapy and sequential chemoradiotherapy in high-risk early-stage cervical cancer by using Meta-analysis.Method PubMed,Embase,The Cochrane Library,CNKI,CBM,VIP and Wanfang database were retrieved and the randomized controlled trials on efficacy and safety of postoperative concurrent chemoradiotherapy and sequential chemoradiotherapy in high-risk early-stage cervical cancer were screened based on inclusion and exclusion criteria.Methodological quality was evaluated for the literature that met the criteria,and Meta-analysis was performed by using RevMan 5.3 software.Result 8 articles on 1382 cases of high-risk early-stage cervical cancer patients were finally included.Meta-analysis showed that compared with the postoperative sequential chemoradiotherapy,the postoperative concurrent chemoradiotherapy can improve the 3-year overall survival rate of patients with high-risk early-stage cervical cancer(OR=3.95,95%CI:2.11-7.39,P<0.01),but cannot improve the 5-year overall survival rate(OR=0.97,95%CI:0.68-1.39,P=0.89).There was no significant difference for the incidence of grade 3-4 bone marrow suppression between patients received postoperative concurrent chemoradiotherapy and sequential chemoradiotherapy(OR=1.21,95%CI:0.91-1.63,P=0.20),but the postoperative concurrent chemoradiotherapy can increase the incidence of grade 3-4 gastrointestinal reactions(OR=2.26,95%CI:1.63-3.14,P<0.01).Conclusion Current evidences show that compared with the postoperative sequential chemoradiotherapy,the postoperative concurrent chemoradiotherapy cannot improve the 5-year survival rate of patients with high-risk early-stage cervical cancer,but increase the incidence of grade 3-4 gastrointestinal reactions.

关 键 词：宫颈癌 同步放化疗 序贯放化疗 META分析 

分 类 号：R737.33[医药卫生—肿瘤]