摘要
目的 评价热疗联合放化疗治疗中晚期食管癌的疗效和安全性.方法 计算机检索the Cochrane Library、PubMed、EMBASE、CBM、CNKI、VIP、WanFang,同时辅以其他检索.收集所有比较放化疗联合热疗与放化疗的RCT.通过文献筛选、数据提取、质量评估,使用Revman 5.1软件进行Meta分析.结果 共纳入21 篇RCT,共1 468 例患者.Meta分析结果显示:HCRT组的完全缓解率及总有效率均高于CRT组,差异均有统计学意义(P<0.05);HCRT组的1、2、3 年生存率均好于CRT组,且差异均有统计学意义(P<0.05);HCRT组恶心呕吐、放射性食管炎、放射性肺炎、骨髓抑制、放射性皮炎的发生率均低于CRT组,但放射性皮炎差异无统计学意义(P>0.05),其他差异有统计学意义(P<0.05).结论 热疗联合放化疗提高了患者的近期疗效及临床受益反应,延长了患者生存率,同时降低了恶心呕吐、放射性食管炎、放射性肺炎及骨髓抑制等不良反应的发生率.但热疗联合放化疗治疗食管癌的疗效及安全性有待更多大样本高质量的RCT进一步验证.
Objective To evaluate the clinical efficacy and safety of chemoradiation combined with hyperthermia for middle and late esophageal cancer. Methods We conducted computer searches of foreign databases, including Cochrane Library, PubMed, EMBASE, and Chinese databases, including CBM, CNKI, VIP, and WanFang;We also reviewed other sources as supplement. All relevant randomized controlled trials (RCTs) were collected to compare HCRT and CRT. After literature screening, data extraction and quality evaluation performed by appropriate criteria, the meta-analyses were conducted using RevMan 5.1 software. Results 21 RCTs were included, comprising 1 468 patients. Meta-analysis showed that complete response and total effective rates of the HCRT group were higher than the CRT group, indicating significant differences (P<0.05);The 1-, 2-, 3- survival rates of the HCRT group were higher than the CRT group, indicating significant differences (P<0.05). The incidence of nausea and vomiting, radiation esophagitis, radiation pneumonia, myelosuppression and radiation dermatitis in HCRT group was lower than that in CRT group, but there was no significant difference in the incidence of radiation dermatitis (P>0.05), and there were significant differences in other indicators (P<0.05). Conclusion Hyperthermia combined with chemoradiation can improve the short-term efficacy and clinical benefit of patients, prolong the survival rate of patients, reduce the incidence of nausea and vomiting, radiation esophagitis, radiation pneumonia and myelosuppression and other adverse reactions. However, additional high-quality and large sample size RCTs will be necessary to further demonstrate the efficacy and safety of HCRT.
作者
田亚丽
柴晓艳
朱介宾
谷敏
TIAN Ya-li;CHAI Xiao-yan;ZHU Jie-bin;GU Min(Suzhou Science and Technology Town Hospital,Suzhou,Jiangsu,215153,China)
出处
《中国血液流变学杂志》
CAS
2019年第2期180-185,共6页
Chinese Journal of Hemorheology
基金
苏州高新区医疗卫生科技计划项目(青年项目)(2017Q006)。
关键词
热疗
放化疗
食管癌
META分析
hyperthermia
chemoradiation
esophageal cancer
Meta-analysis
