靶向治疗时代减瘤手术在转移性肾细胞癌中的作用的Meta分析  

The Role of Tumor Reduction Surgery in the Era of Targeted Therapy in Metastatic Renal Cell Carcinoma:A Meta-Analysis

作　　者：胡健 高亮 张元峰 梁培禾[1] Hu Jian;Gao Liang;Zhang Yuanfeng(Department of Urology,The Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院泌尿外科,重庆400010

出　　处：《四川医学》2022年第4期363-368,共6页Sichuan Medical Journal

摘　　要：目的转移性肾细胞癌(mRCC)患者行减瘤手术(CN)的价值目前存在争议,本研究旨在评估CN对接受靶向治疗(TT)的mRCC患者预后的影响。方法系统检索PubMed,Cochrane Library,Web of Science Clinical Trials.gov等数据库收录的关于CN在接受TT治疗的mRCC患者的作用临床研究,时间为从建库至2021年10月,按照标准筛选符合要求的研究,采用Rev Man 5.4软件进行Mate分析。结果本荟萃分析最终纳入12项研究,其中11项为回顾性研究,1项为随机对照试验,共纳入4537例mRCC患者。合并结果显示,与TT单用相比,TT联合CN方案,与更长的总体生存率(OS)相关(HR 0.59,95%CI 0.49~0.71,P<0.001),但无进展生存期(PFS)的差异无统计学意义(HR 0.99,95%CI 0.66~1.49,P=0.98)。结论与TT单用相比,可能带给TT与CN联合治疗进行mRCC患者更好的OS。Objective The role of cytoreductive nephrectomy(CN)for patients with metastatic renal cell carcinoma(mRCC)was still controversial.The purpose of this study was to evaluate the effect of CN on the outcome of mRCC patients receiving targeted therapy(TT).Methods PubMed,Cochrane Library,Web of Science,and Clinical Trials.gov were systematically searched for studies that exploring the efficacy of CN on survival outcomes in mRCC patients following TT.Eligible studies were excluded on the basis of selection criteria,and data was then extracted.Hazard ratios(HR)and 95%confidence intervals(CI)of overall survival(OS)and progression-free survival(PFS)were pooled using Review Manager 5.4.Results A total of 12 studies with 4537 mRCC patients,including 11 retrospective studies and 1 randomized contrail trial,were included in this Meta-analysis.The pooled results showed that CN following TT was significantly associated with longer OS(HR 0.59,95%CI 0.49~0.71,P<0.001)compared with TT alone,but no significant difference was found in PFS(HR 0.99,95%CI,0.66~1.49,P=0.98).Conclusions Compared with TT alone,mRCC patients possibly achieve better OS with TT and CN.

关 键 词：转移性肾细胞癌 减瘤手术 靶向治疗 META分析 

分 类 号：R737.11[医药卫生—肿瘤]