摘要
目的采用循证医学的方法评价同步放化疗与序贯放化疗在食管癌治疗中的有效性和安全性。方法电子检索Cochrane Library、Pubmed、Embase、CNKI、VIP、CBM、万方,手工检索相关杂志、会议论文、学位论文,收集同步放化疗对比序贯放化疗治疗食管癌的临床随机对照试验(RCT),检索时间为各数据库建库至2012年8月,对文献进行质量评价,按照Cochrane handbook并采用RevMan 5.1软件对数据进行Meta分析。结果纳入9项RCT,共收入754例患者。结果显示,同步放化疗与序贯放化疗治疗食管癌比较,总有效率和1、2、3年生存率以及局控率同步组均高于序贯组,差异有统计学意义(P<0.05);远处转移两组间差异无统计学意义(P=0.85);放射性食管炎、胃肠道反应的发生同步组较序贯组高(P<0.05)。血液学毒性中白细胞减少有统计学意义(P<0.05),而血小板减少无统计学意义(P=0.53)。结论 Meta分析表明,同步放化疗治疗食管癌近期疗效及1、2、3年生存率和局控率优于序贯放化疗,但放射性食管炎、血液学毒性中的白细胞减少及胃肠道反应高于序贯组。
Objective To evaluate the efficacy and safety of concurrent chemoradiotherapy and sequential chemoradiotherapy for esophageal cancer. Methods Literatures were retrieved from Cochrane Library, Embase, CNKI, VIP, CBM, Wanfang and other databases by computer and those from conference papers and thesis by hand. Randomized control trials （RCT） of concurrent chemoradiotherapy and sequential chemoradiotherapy for treatment of esophageal cancer were collected. The duration of searching was from the establishment of the databases up to August 2012. Meta-analysis was conducted using RevMan 5.1 software, in accordance with the cochrane handbook. Results The meta-analysis included 9 RCTs and involved 754 patients. The meta-analysis showed that the overall efficacy, 1, 2, 3-y survival rates and local control rates in concurrent chemoradiotherapy group were higher than those in sequential chemoradiotherapy group （ P 〈 0. 05 ）. There was no significant difference in distant metastases between two groups （ P = 0. 85 ）. The incidence of radiation esophagitis and gastrointestinal reactions in concurrent group was higher than that in sequential group （P 〈 0.05）. There was significant difference in the incidence of leukopenia （ P 〈 0.05 ）, but not in thrombocytopenia between two groups （ P = 0.53 ）. Conclusion Concurrent chemoradiotherapy has better short-term efficacy and higher 1, 2, 3-y survival and local control rates than sequential chemotherapy in treatment of esophageal cancer, but has higher toxicity rate.
出处
《实用肿瘤杂志》
CAS
2013年第6期605-611,共7页
Journal of Practical Oncology
关键词
食管肿瘤
药物疗法
食管肿瘤
放射疗法
META分析
随机对照试验
esophageal neoplasms/drug therapy
esophageal neoplasms/radiotherapy
meta-analysis
randomized controlledtrial
