体部立体定向放疗联合化疗治疗晚期胰腺癌临床效果的Meta分析  

Clinical effect of body stereotactic radiotherapy combined with chemotherapy in the treatment of advanced pancreatic cancer: A Meta-analysis

作　　者：吕永双 刁睿 陈治梁 余天雾[1] LYU Yong-shuang;DIAO Rui;CHEN Zhi-liang;YU Tian-wu(Department of Hepatobiliary Surgery,Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院肝胆外科,重庆402160

出　　处：《中国现代普通外科进展》2023年第3期202-208,224,共8页Chinese Journal of Current Advances in General Surgery

摘　　要：目的 :采用循证医学的方法评价体部立体定向放疗联合化疗治疗晚期胰腺癌的临床效果。方法:通过检索中国知网、万方、维普、Pub Med、Embase数据库,收集有关体部立体定向放疗联合化疗治疗晚期胰腺癌相临床研究,检索时限均从建库至2021年6月。依据事先设置的文献纳入与排除标准,筛选出符合要求的临床研究,应用Rev Man 5.3软件进行Meta分析。结果:共纳入21项临床研究,总计1738例患者。Meta分析结果显示,对于晚期胰腺癌患者,使用立体定向放疗联合化疗与单独化疗比较,有较好的客观有效率(Z=9.59,P<0.001,OR=4.71,95%CI:3.43~6.46)、1年生存率(Z=5.00,P<0.001,OR=2.36,95%CI:1.69~3.31)、2年生存率(Z=3.61,P<0.001,OR=2.76,95%CI:1.59~4.79),骨髓抑制发生率(Z=0.07,P=0.95,OR=0.98,95%CI:0.51~1.87)和消化道反应发生率(Z=0.01,P=0.99,OR=1.0,95%CI:0.58~1.72)差异无统计学意义;使用立体定向放疗联合化疗与单独体部立体定向放疗比较,有较高的客观有效率(Z=4.97,P<0.001,OR=2.68,95%CI:1.82~3.95)、2年生存率(Z=4.40,P<0.001,OR=3.86,95%CI:2.11~7.04)和骨髓抑制发生率(Z=2.49,P=0.01,OR=4.51,95%CI:1.38~14.72),1年生存率Z=0.84,P=0.40,OR=1.46,95%CI:0.60~3.54)和消化道反应发生率(Z=0.84,P=0.40,OR=1.68,95%CI:0.50~5.57)差异无统计学意义。结论:立体定向放疗联合化疗治疗晚期胰腺癌有较好的临床效果,这些结果还需要未来在大样本、高质量的随机对照试验中进行评估。Objective:Evaluate the clinical effect of stereotactic body radiotherapy combined with chemotherapy in the treatment of advanced pancreatic cancer with the method of evidence-based medicine.Metheds:By searching CNKI,Wanfang,VIP,PubMed,and Embase databases,we collected clinical studies on body stereotactic radiotherapy combined with chemotherapy in the treatment of advanced pancreatic cancer.The retrieval time was from the establishment of the database to June 2021.According to the pre-set literature inclusion and exclusion criteria,the clinical studies that met the requirements were screened out,and RevMan 5.3 software was used for meta-analysis.Results:A total of 21 clinical studies were included,with a total of 1738 patients.Meta-analysis results show that:For patients with advanced pancreatic cancer,Compared with chemotherapy,the use of stereotactic radiotherapy combined with chemotherapy has better objective response rate(Z=9.59,P<0.001,OR=4.71,95%CI:3.43~6.46),higher 1-year survival rate(Z=5.00,P<0.001,OR=2.36,95%CI:1.69~3.31)and 2-year survival rate(Z=3.61,P<0.001,OR=2.76,95%CI:1.59~4.79),The incidence of myelosuppression(Z=0.07,P=0.95,OR=0.98,95%CI:0.51~1.87)and the incidence of gastrointestinal reactions(Z=0.01,P=0.99,OR=1.0,95%CI:0.58~1.72)No statistical significance;Compared with body stereotactic radiotherapy,the use of stereotactic radiotherapy combined with chemotherapy has higher objective response rate(Z=4.97,P<0.001,OR=2.68,95%CI:1.82~3.95),2-year survival rate(Z=4.40,P<0.001,OR=3.86,95%CI:2.11~7.04),and incidence of myelosuppression(Z=2.49,P=0.01,OR=4.51,95%CI:1.38~14.72).The 1-year survival rate(Z=0.84,P=0.40,OR=1.46,95%CI:0.60~3.54)and the incidence of gastrointestinal reactions(Z=0.84,P=0.40,OR=1.68,95%CI:0.50~5.57)were not statistically significant.Conclusion:Stereotactic radiotherapy combined with chemotherapy has good clinical effects in the treatment of advanced pancreatic cancer.These results need to be evaluated in large-sample,high-quality randomized controlled trials in the future.

关 键 词：胰腺肿瘤 体部立体定向放疗 化疗 META分析 

分 类 号：R735.9[医药卫生—肿瘤]