摘要
目的:评价热放化疗治疗晚期宫颈癌近期疗效和安全性,为临床治疗及更深入研究提供参考。方法:计算机检索PubMed、EMBASE、Cochrane Library、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)、中国期刊全文数据库(CNKI)及中华医学会数字化期刊(WANFANG Data),并辅以手工检索,收集热放化疗治疗晚期宫颈癌的随机对照试验(RCT),检索时间由各数据库建库至2013年5月。采用Cochrane系统评价手册文献质量评价标准评价纳入研究质量,用RevMan 5.2软件进行Meta分析。结果:本研究纳入16篇RCT,共1 295例患者。结果显示:①热放化疗组在近期疗效(治疗结束时的完全缓解率、治疗结束后3个月肿瘤局部控制率)方面均高于放化疗组、热放疗组及单放疗组,差异有统计学意义,而在治疗结束后1个月的有效率方面高于放化疗组及单放组,差异有统计学意义。远期疗效方面,热放化疗组1年无瘤生存率较放化疗组及热放疗组高,差异有统计学意义;2年及5年生存率,热放化疗组与放化疗组、单放疗组及热放疗组差异无统计学意义;3年生存率,热放化疗组与放化疗组及单放组差异无统计学意义,但高于热放组,差异有统计学意义。②近期毒副反应(膀胱反应、直肠反应、干性皮炎),热放化疗组与其他3组比较差异无统计学意义。但消化道反应及骨髓抑制方面,热放化疗组较单放疗组和热放疗组高,差异有统计学意义,经药物治疗后患者能够耐受。远期毒副反应(放射性膀胱炎和放射性直肠炎),热放化疗组与其他3组比较差异无统计学意义。结论:与其他治疗方法相比,热放化综合治疗宫颈癌有提高疗效的趋势,并不增加其远期毒副反应,今后仍需开展更多高质量研究就其近期及远期疗效、近期及远期毒副反应方面进行研究。
Objective： To evaluate the clinical effect and safety of hyperthermia combined with radiotherapy and chemotherapy（HRCT） for advanced cervical cancer. Methods：The database such as, The Cochrane library, PubMed, EMBASE, CBM,CNKI,VIP and WANFANG Data were searched up to May of 2013, and other sources as supplied were also retrieved to collect all the relevant randomized controlled trials （RCTs） on comparing HCRT with non-HCRT .The quality of the included trials was assessed according to the Cochrane Hand book 5.1 for systematic review and the features of this study as well. Meta-analyses were conducted by using RevMan 5.2 software. Results：A total of sixteen RCTs involving 1 295 patients were included. The results of Meta-analysis showed that①HCRT group′s short-term efficacy （complete remission rate,local control rate）were higher than HRT group,CRT group and RT group. HCRT group′s efficiency rate were higher than CRT group and RT group. HCRT group′s long-term efficacy：one year disease-free survival rate was higher than CRT group and HRT group. In terms of two-year and five-year survival rate, there were no significant differences compared with non-HCRT. In terms of three-year survival rate,there were no significant differences compared with CRT group and RT group,but was higher than HRT group.② Safety evaluation：the incidence rates of bladder reaction , rectum reaction and dry dermatitis were similar among the HCRT group and the non-HCRT group .There were no significant differences in HCRT compared with non-HCRT. Considering the incidence rates of gastrointestinal reaction,marrow suppression, HCRT group was higher than RT and HRT group. There were significant differences between HCRT group and RT and HRT group . Conclusions：Compared with other therapies,HCRT tends to improve the clinical efficacy ,but this result needs to be proved by more clinical trails. HCRT is superior to the routine radio-chemotherapy in efficacy,but the relevant evidence for proving its long-term efficacy and
出处
《国际妇产科学杂志》
CAS
2014年第3期298-303,共6页
Journal of International Obstetrics and Gynecology
关键词
宫颈肿瘤
癌
热疗
放射疗法
抗肿瘤联合化疗方案
META分析
Uterine cervical neoplasms
Caicinoma
Hyperthermia
Radiotherapy
Antineoplastic combined chemotherapy protocols
Meta-analysis
