摘要
目的系统评价单纯三维适形放射治疗(放疗)与同步化学治疗(化疗)在局部晚期非小细胞肺癌治疗中的疗效与安全性。方法计算机检索Cochrane Database of Systematic Reviews、Medline、EMbase、OpenSIGLE、National Technical Information Service(NTIS)、中国知网(CNKI)、维普数据库(VIP)、万方数据库和CBM中关于三维适形放疗联合化疗治疗局部晚期非小细胞肺癌疗效评估的随机对照试验(RCT),同时追索纳入文献的参考文献。检索时限均从建库至2011年10月。由两名研究者对纳入研究的质量进行严格评价和资料提取,对符合质量标准的RCT进行Meta分析。统计学分析采用RevMan5.0.25软件。结果共纳入12个RCT,Meta分析5个主要结局指标的结果显示:单纯三维适形放疗与同步化疗比较,有效率和局部症状改善差异有统计学意义[分别为OR=2.52,95%CI(1.41,4.52)和OR=3.22,95%CI(1.32,7.83)],放射性食管炎、放射性肺炎和骨髓抑制程度差异无统计学意义。结论现有研究表明,三维适形放疗联合化疗可明显改善患者局部症状,提高治疗有效率,且大部分患者可耐受毒副作用,临床医师可将联合化疗作为强推荐。但鉴于纳入研究较少,样本量小,质量不高,仍需开展大样本、多中心、方法科学和规范的高质量RCT,以进一步验证二者的联合治疗效果。
Objective To evaluate the efficacy and safety of three-dimensional conformal radiation therapy synchronized with chemotherapy in patients with locally advanced non-small cell lung cancer. Methods The literature related to evaluation of the three-dimensional conformal radiation therapy plus chemotherapy for the patients with locally advanced non- small cell lung cancer were retrieved from Cochrane Database of Systematic Reviews, MEDLINE, EMbase, OpenSIGLE, National Technical Iniormation Service （NTIS） ,CNKI,VIP, Wanfang database and CBM from the day of database establishment till the october 2011. Two authors independently appraised the quality of the reference research, extracted the data, and performed Meta analysis to the RCTs which met the quality standards. The extracted data were analyzed by RevManS. 0.25 . Results A total of 12 trials were included. Meta analysis of five key outcome indicators showed that three-dimensional conformal radiation therapy with concurrent chemotherapy had significantly improved the treatment efficiency and local symptoms [ OR = 2.52, 95% CI （1.41,4.52） and OR = 3.22,95% CI （1.32,7.83） respectively]. But, no conspicuously difference was found in radiation esophagitis, radiation pneumonitis and bone marrow suppression degree. Conclusion The current evidence shows that three- dimensional conformal radiotherapy combined with chemotherapy can significantly improve local symptoms and treatment efficiency in patients with locally advanced non-small cell lung cancer, and most patients can tolerate the side ettects, clinicians may recommend the combination therapy over radiation alone. Due to the limitations of the included studies, more large-scale, high-quality RCTs are required.
出处
《医药导报》
CAS
北大核心
2013年第2期178-185,共8页
Herald of Medicine
基金
国家自然科学基金资助项目(30970860)
关键词
化学治疗
同步
三维适形放疗
肺癌
非小细胞
局部
晚期
随机对照试验
系统评价
Meta分析
Concurrent chemotherapy
Three-dimensional conlbrmal radiotherapy
Locally advanced non-small cellLung cancer
Randomized controlled trial
System review
Meta-analysis
