不可逆电穿孔术联合新辅助化疗治疗局部进展期胰腺癌安全性和有效性的Meta分析  

Safety and Efficacy of Irreversible Electroporation Combined with Neoadjuvant Chemotherapy for Locally Advanced Pancreatic Cancer:A Meta-analysis

作　　者：赵宝银 梁昭君 张丽霞 陈顺 贾栋 仵朝晖 李斌[1] 王俊科 马俊 于晓辉 ZHAO Baoyin;LIANG Zhaojun;ZHANG Lixia;CHEN Shun;JIA Dong;WU Zhaohui;LI Bin;WANG Junke;MA Jun;YU Xiaohui(The First Clinical Medical College,Gansu University of Traditional Chinese Medicine,Lanzhou 730000,China;Department of Gastroenterology,940th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force,Lanzhou 730050,China;Laboratory of Basic Medicine,940th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force,Gansu Key Laboratory of Stem Cells and Genetic Drugs,Lanzhou 730050,China)

机构地区：[1]甘肃中医药大学第一临床医学院,兰州730000 [2]中国人民解放军联勤保障部队第九四〇医院消化内科,兰州730050 [3]中国人民解放军联勤保障部队第九四〇医院基础医学实验室,甘肃省干细胞与基因药物重点实验室,兰州730050

出　　处：《肿瘤防治研究》2022年第11期1139-1145,共7页Cancer Research on Prevention and Treatment

基　　金：甘肃省自然科学基金(20YF8FA099);甘肃省科技厅社发处临床医学研究中心项目(21JR7RA017)。

摘　　要：目的评估不可逆电穿孔术(IRE)联合新辅助化疗治疗局部进展期胰腺癌患者的安全性和有效性。方法检索PubMed、Embase、Cochrane Library、Web of Science、中国生物医学文献数据库、知网、万方和维普等数据库从建库至2022年3月发表的相关文献。采用RevMan5.4软件进行Meta分析。结果最终纳入8项研究,其中随机对照试验1项、回顾性研究4项和前瞻性研究3项。共3970例局部进展期胰腺癌患者,其中联合组344例,单纯化疗组3626例。Meta分析显示联合组患者的总生存期明显高于单纯化疗组(OR=4.52,95%CI:2.63~7.77,P<0.00001)。但是联合组和单纯化疗组患者的疾病控制率差异无统计学意义(OR=0.58,95%CI:0.02~18.74,P=0.76),疾病进展两组差异无统计学意义(OR=0.49,95%CI:0.23~1.02,P=0.06)。新辅助化疗联合IRE对患者治疗期间胃肠道反应(OR=0.37,95%CI:0.10~1.34,P=0.13)和骨髓抑制(OR=0.61,95%CI:0.26~1.40,P=0.24)等不良反应的发生率并无明显影响。结论不可逆电穿孔术联合新辅助化疗可以显著改善局部进展期胰腺癌患者的预后,明显提高患者的总生存时间。Objective To evaluate the safety and efficacy of irreversible electroporation(IRE)combined with neoadjuvant chemotherapy in patients with locally advanced pancreatic cancer.Methods We searched PubMed,Embase,Cochrane Library,Web of Science,China Biomedical Literature Database,CNKI,Wanfang,and VIP databases for articles dated from the establishment of each database to March 2022.Metaanalysis was performed using RevMan5.4 software.Results A total of 3970 patients with locally advanced pancreatic cancer were enrolled in eight studies,including one randomized controlled trial,four retrospective studies,and three prospective studies.The patients were divided into the combined therapy group with 344 patients and the chemotherapy-only group with 3626 patients.Meta-analysis showed that the overall survival of patients in the combined therapy group was significantly higher than that in the chemotherapy-only group(OR=4.52;95%CI:2.63-7.77;P<0.00001).However,no significant difference existed in the disease control rate between the combined therapy group and the chemotherapy-only group(OR=0.58;95%CI:0.02-18.74;P=0.76).Moreover,no significant difference existed in the disease progression between the two groups(OR=0.49;95%CI:0.23-1.02;P=0.06).The combination of neoadjuvant chemotherapy and IRE had no significant effect on the incidence of adverse reactions of gastrointestinal reaction(OR=0.37;95%CI:0.10-1.34;P=0.13)and bone marrow suppression(OR=0.61;95%CI:0.26-1.40;P=0.24).Conclusion IRE combined with neoadjuvant chemotherapy can remarkably improve the prognosis of patients with locally advanced pancreatic cancer,and significantly prolong the overall survival.

关 键 词：不可逆电穿孔术 新辅助化疗 胰腺癌 安全性 有效性 META分析 

分 类 号：R735.9[医药卫生—肿瘤]