Ⅲ(N_(2))期非小细胞肺癌术后放疗疗效的meta分析  

The efficacy of postoperative radiotherapy in stageⅢ(N_(2))non-small cell lung cancer:a meta analysis

作　　者：凌丽仙 周师师 郑红娟 尹瑞华 唐梦君 傅健飞[1] Ling Lixian;Zhou Shishi;Zheng Hongjuan;Yin Ruihua;Tang Mengjun;Fu Jianfei(Department of Medical Oncology,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua 321000,China;Department of Radiation,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua 321000,China)

机构地区：[1]浙江大学医学院附属金华医院肿瘤内科,金华321000 [2]浙江大学医学院附属金华医院放疗科,金华321000

出　　处：《中华放射肿瘤学杂志》2023年第4期293-300,共8页Chinese Journal of Radiation Oncology

基　　金：金华市中心医院中青年科研启动基金(2021-4-040)。

摘　　要：目的应用meta分析比较术后放疗对Ⅲ(N_(2))期非小细胞肺癌生存的影响。方法计算机检索万方数据库、PubMed、Cochrane Library等数据库,搜集关于Ⅲ(N_(2))期非小细胞肺癌术后放疗的相关研究,检索时限为2006年1月至2022年1月。由2名研究者独立进行文献筛选、资料提取,并对纳入的文献进行偏倚风险评估。运用R4.0.3软件对纳入文献进行meta分析。结果总共纳入12篇文献,共计2992例患者,术后放疗组1479例,对照组1513例。meta分析结果显示,术后放疗可以提高总生存(OS)率及无瘤生存(DFS)期。进一步进行meta亚组分析:6项随机对照试验结果表明,术后放疗不能显著降低死亡风险(HR=0.98,95%CI为0.80~1.20);6项回顾性研究结果表明,术后放疗可以改善预后(HR=0.68,95%CI为0.59~0.79)。多个/多站同侧纵隔和/或隆突下淋巴结转移(N2)患者接受术后放疗能够改善OS(HR=0.89,95%CI为0.80~0.99)。结论术后放疗可以改善Ⅲ(N_(2))期非小细胞肺癌的OS及DFS,在多个/多站N_(2)转移的亚组中观察到获益趋势。Objective To conduct meta analysis to compare the effect of complete resection with or without postoperative radiotherapy(PORT)on survival in stageⅢ(N_(2))non-small cell lung cancer(NSCLC).Methods Relevant studies of the efficacy of PORT for stageⅢ(N_(2))NSCLC were searched from Wanfang Data,PubMed,and Cochrane Library from January 2006 to January 2022.Literature screening,extraction of information and assessment of the risk of bias of the included literature was carried out by two independent researchers.Meta analysis was performed using R4.0.3 software.Results A total of 12 publications consisting of 2992 patients were included,1479 cases in the PORT group and 1513 cases in the control group.PORT improved the overall survival(OS)and disease free survival(DFS)compared to the control group.Fixed-effects model meta analysis of 6 randomized controlled trials showed that PORT did not significantly reduce the risk of death(HR=0.98,95%CI:0.80-1.20).Fixed-effects model meta analysis of 6 retrospective studies showed that PORT improved prognosis(HR=0.68,95%CI:0.59-0.79).PORT could improve OS of patients with multiple(station)metastasis of ipsilateral mediastinum and/or submandibular lymph nodes(HR=0.89,95%CI:0.80-0.99).Conclusions PORT could improve OS and DFS in stageⅢ(N_(2))NSCLC.A trend towards benefit can be observed in the subgroup with multiple/multi-station N_(2)metastasis.

关 键 词：癌 非小细胞肺 术后放射疗法 N_(2)期 荟萃分析 

分 类 号：R734.2[医药卫生—肿瘤]