| 引用本文: | 张艳,沈建军,沈琦,陈若,张红雁.胃癌术后同步放化疗与单纯化疗的疗效及毒副反应的meta分析[J].中国临床新医学,0,():-. |
| ZhangYan.胃癌术后同步放化疗与单纯化疗的疗效及毒副反应的meta分析[J].中国临床新医学,0,():-. |
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| 摘要: |
| 背景：胃癌术后同步放化疗或单纯化疗较单纯手术而言均可提高疗效，本文评价胃癌术后同步放化疗与单纯化疗的疗效与毒副反应，确定胃癌术后更佳的治疗方案。
方法：两名研究者分别检索MEDLINE, EMBASE 和 Cochrane library及中国知网、万方、维普等文献检索库，时间为建库到2018年7月。共纳入21篇随机对照试验，共计2299名研究对象，主要结局指标为3年、5年总生存率(Overall Survival, OS），次要结局指标为3年、5年无疾病进展期(Disease-free Survival, DFS)和毒性反应。研究纳入P值、RR风险比、95%置信区间以及发表偏倚。
结果：术后同步放化疗较单纯化疗提高了3年及5年总生存率（RR, 0.737 ; 95% CI 0.664-0.819; P= 0.000; RR, 0.818 ; 95% CI 0.718-0.932; P= 0.003）; 3年及5年无疾病进展生存期（RR, 0.770; 95% CI 0.686- 0.864; P=0.000; RR, 0.772; 95% CI 0.620-0.962; P=0.021），但增加了III度及以上的消化道系统及血液学系统的毒副反应（RR, 1.455; 95% CI 1.134-1.868; P= 0.003；RR, 1.208; 95% CI 1.036-1.410; P= 0.016）。
结论：胃癌术后同步放化疗可延长总生存期及无疾病进展生存期，但增加了治疗相关毒副反应。
关键词：胃肿瘤 放射治疗 药物治疗 |
| 关键词: 胃肿瘤 放射治疗 药物治疗 |
| DOI： |
| 分类号: |
| 基金项目:安徽省自然科学基金 Ras调控Ezrin对胃癌放疗敏感性的影响及其分子机制的研究 |
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| A meta analysis of the efficacy and side effects of concurrent chemoradiotherapy and chemotherapy after gastric cancer surgery |
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ZhangYan
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Anhui provincial hospital
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| Abstract: |
| A meta analysis of the efficacy and side effects of concurrent chemoradiotherapy and chemotherapy after gastric cancer surgery
ZHANGYan1 SHENJian-Jun1 SHENQi1
1Anhui provincial hospital affiliated to anhui medical university, HeFei, China 230001
Introduction: Postoperative chemo-radiotherapy (ChRT) or chemotherapy (Ch) both can improve the curative effect of patients with resectable gastric cancer. The meta-analysis aim to evaluate the curative effect and toxic and side effect between postoperative ChRT and Ch to detemine the better treatment options.
Methods: Two investigators independently searched MEDLINE, EMBASE, Cochrane library, CNKI,CQVIP and Wangfang Database through July 2018 for randomized controlled trials(RCTs) comparing postoperative ChRT with Ch. Twenty one RCTs comparing postoperative ChRT with Ch(n=2299) were included and 2299 patients were included. The primary outcome was 3- and 5-year overall survival(OS); while the secondary outcomes were 3- and 5- year disease free survival (DFS) and toxicity. P value (P), Risk ratio(RR) and 95% confidence intervals (CIs) were calculated, and publication bias was analyzed.
Results: Postoperative ChRT improved 3- and 5-year OS and 3- and 5- DFS compared to postoperative Ch (RR, 0.737 ; 95% CI 0.664-0.819; P= 0.000; RR, 0.818 ; 95% CI 0.718-0.932; P= 0.003; RR, 0.770; 95% CI 0.686- 0.864; P=0.000; RR, 0.772; 95% CI 0.620-0.962; P=0.021). But also increase digestive system toxicity and hematological system toxicity（RR, 1.455; 95% CI 1.134-1.868; P= 0.003；RR, 1.208; 95% CI 1.036-1.410; P= 0.016）。
Conclusions: ChRT improved 3- and 5-year OS and 3- and 5-year DFS as compared to Ch alone, but
also increase toxicities.
Key words：Gastric cancer; Radiotherapy; Chemotherapy |
| Key words: gastric cancer, radiotherapy, chemotherapy |
