摘要
目的:探讨并比较早期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者行手术治疗、立体定向放射治疗(stereotactic body radiotherapy,SBRT)及经皮穿刺消融治疗的效果。方法:检索PubMed、EMBASE、Cochrane Library、Web of Science及中国知网、万方、维普、CBM等中英文数据库中已发表的手术、SBRT及经皮穿刺消融治疗早期NSCLC的相关文献。提取结局指标总生存率(overall survival,OS)和无进展生存率(progression-free survival,PFS)的风险比(hazard ratio,HR)及其95%CI,使用R软件进行网状荟萃分析并评价结果。结果:纳入文献38篇,其中手术患者2964例,SBRT患者1960例,消融治疗患者378例。以OS为结局合并后,与手术对比,SBRT HR=1.55(95%CI:1.31~1.81),消融HR=1.46(95%CI:1.04~2.05);以PFS为结局合并后,与手术对比,SBRT HR=1.56(95%CI:1.23~1.97),消融HR=1.73(95%CI:1.19~2.56)。结论:手术组患者OS和PFS的HR最低,目前证据提示手术治疗对早期NSCLC患者效果最好。SBRT及经皮穿刺消融效果相近,可用于无法耐受手术的患者,用于可手术患者治疗效果有待进一步评价。
Objective:To investigate and compare the effects of surgery,stereotactic body radiotherapy(SBRT),and percutaneous ablation in patients with early non-small cell lung cancer(NSCLC).Methods:Eligible studies about surgical treatment,SBRT,and percutaneous ablation for early NSCLC were retrieved from PubMed,EMBASE,Cochrane Library,Web of Science and Chinese databases such as CNKI,Wanfang,VIP and CBM.The hazard ratio(HR)and 95%CI of the overall survival(OS)rate and progression-free survival(PFS)rate were extracted,and the R software was used to perform the Bayesian network meta-analysis and evaluate the results. Results: A total of 38 studies were included, including 2 964 patients treated with surgery, 1 960 patients treated with SBRT, and 378 patients treated with percutaneous ablation. Compared with surgery, the HR of pooled OS with SBRT was 1.55 (95%CI: 1.31 to 1.81), the HR of pooled OS with ablation was 1.46 (95%CI: 1.04 to 2.05);the HR of pooled PFS with SBRT was 1.56 (95%CI: 1.23 to 1.97), and the HR of pooled PFS with ablation was 1.73 (95%CI: 1.19 to 2.56). Conclusion: The HR of OS and PFS in patients with surgical treatment is the lowest, indicating that surgical treatment has the best effect on patients with early NSCLC. The effects of SBRT and percutaneous puncture are similar. More evidences are needed to further evaluate the using of SBRT and ablation in operable patients.
作者
郝鹏
肖洪秋
李曈
田辉
HAO Peng;XIAO Hongqiu;LI Tong;TIAN Hui(Department of Thoracic Surgery,Qilu Hospital of Shandong University,Jinan 250000,China)
出处
《临床与病理杂志》
CAS
2022年第8期1799-1814,共16页
Journal of Clinical and Pathological Research
关键词
非小细胞肺癌
治疗
手术
立体定向放射治疗
消融
网状荟萃分析
non-small cell lung cancer
treatment
surgery
stereotactic body radiation therapy
ablation
network Meta-analysis
