新辅助化疗应用于Ⅲa期非小细胞肺癌的效果评价  

Evaluation of neoadjuvant chemotherapy for stage Ⅲ a non-small cell lung cancer

作　　者：赵阳 杨丽涛 苑广奎 马磊 董峰言 周新凤 王志鹏 ZHAO Yang;YANG Litao;YUAN Guangkui;MA Lei;DONG Fengyan;ZHOU Xinfeng;WANG Zhipeng(Department of Thoracic Surgery,the Affiliated Hospital of Weifang Medical University,Weifang 261031,China;Fever Ward,Weifang Traditional Chinese Hospital;Department of Critical Medicine,Weifang Traditional Chinese Hospital)

机构地区：[1]潍坊医学院附属医院胸外科,山东潍坊261031 [2]潍坊市中医院发热病房 [3]潍坊市中医院重症医学科

出　　处：《潍坊医学院学报》2021年第6期414-417,I0001,I0002,共6页Acta Academiae Medicinae Weifang

摘　　要：目的系统评价新辅助化疗应用于Ⅲa期非小细胞肺癌(NSCLC)患者的收益性及疗效。方法计算机检索Wanfang Data数据库、Web of Science、PubMed、EMbase、CNKI、the Cochrane Library、VIP、CBM数据库,搜集关于新辅助化疗治疗Ⅲa期非小细胞肺癌的随机对照试验(RCT),检索时限均从建库至2020年10月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入15个RCT,包括1899例非小细胞肺癌患者。Meta分析结果显示:新辅助化疗组的手术R;切除率明显高于对照组(OR=2.04,95%CI:1.52-2.74,P<0.05),且两组术后并发症差异无统计学意义(OR=1.23,95%CI:0.89-1.69,P=0.22);新辅助化疗可提高患者的1年(OR=1.65,95%CI:1.23-2.22,P=0.0008)、3年(OR=2.18,95%CI:1.67-2.86,P<0.05)、5年(OR=2.09,95%CI:1.24-3.53,P=0.005)生存率,差异具有统计学意义。结论新辅助化疗联合手术能提高Ⅲa期非小细胞肺癌患者的手术R;切除率和患者的1年、3年、5年生存率,且不增加患者的术后并发症。受纳入研究的数量和质量限制,上述结论仍需开展更多高质量研究予以验证。Objective To systematically evaluate the profitability and efficacy of neoadjuvant chemotherapy in patients with stage Ⅲa non-small cell lung cancer.Methods Randomized controlled trials on neoadjuvant chemotherapy for stage Ⅲa non-small cell lung cancer were collected from Wanfang Data database, Web of Science, PubMed, EMbase, CNKI,the Cochrane Library, VIP and CBM databases.The search time limit is from the establishment of the database to October 2020.Two independent reviewers screened the literature, extracted data and assessed the risk of being included in the study.Meta-analysis was performed using RevMan 5.3 software.Results A total of 15 RCT were included, including 1899 patients with non-small cell lung cancer.The results of Meta analysis showed that the resection rate of R;in neoadjuvant chemotherapy group was significantly higher than that in control group(OR=2.04,95%CI:1.52-2.74,P<0.05),and there was no significant difference in postoperative complications between two groups(OR=1.23,95%CI:0.89-1.69,P=0.22).In terms of survival rate, the neoadjuvant chemotherapy group could improve 1 year survival rates(OR=1.65,95%CI:1.23-2.22,P=0.0008),3 years survival rates(OR=2.18,95%CI:1.67-2.86,P<0.05),and 5 years survival rates(OR=2.09,95%CI:1.24-3.53,P=0.005).Conclusion Compared with the control group, neoadjuvant chemotherapy can improve the surgical R;resection rate and the one, three and five year survival rates of patients with stage Ⅲa non-small cell lung cancer without increasing the postoperative complications.Due to the quantity and quality limitations of the included studies, the above conclusion still needs to be verified by more high-quality research.

关 键 词：新辅助化疗 Ⅲa期 非小细胞肺肿瘤 META分析 

分 类 号：R734.2[医药卫生—肿瘤]