食管鳞癌同期放化疗荟萃分析

doi:10.3760/cma.j.issn.1004-4221.2013.06.007

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摘要目的分析同期放化疗在我国非手术治疗食管鳞癌的疗效及不良反应,为其临床应用提供循证医学证据。方法检索CNKI、万方医学网数据库中有关食管癌同期放化疗的随机对照研究,应用荟萃分析方法评价国内食管鳞癌同期放化疗的疗效及安全性。结果纳入符合标准的随机或病例对照研究39项共4161例患者。荟萃分析显示同期放化疗较单纯放疗可明显提高食管癌患者的近期疗效(OR=2.588,P=0.000)和1、3、5年生存率(HR=1.995,P=0.000;HR=2.047,P=0.000;HR=2.265,P=0.000),但≥3级放射性食管炎、≥2级放射性肺炎及≥3级骨髓抑制发生率也显著升高(OR=4.372,P=0.000;OR=1.962,P=0.005;OR=4.403,P=0.000)。同期放化疗含紫杉类方案较FP方案可提高近期疗效(OR=1.868,P=0.036),1、3年生存率相似(HR=1.087,P=0.781;HR=1.315,P=0.569)。

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	王军
	于金明
	景绍武
	程云杰
	刘青
	王祎
	曹峰
	杨从容

关键词 ：食管肿瘤/同期放化疗法, 预后, 荟萃分析

Abstract：Objective To analyze the efficacy and toxicities of concurrent chemoradiotherapy (CCRT) in the non-surgical treatment of esophageal squamous cell carcinoma (ESCC) in China and to provide evidence for its clinical application. Methods CNKI and Wanfang Data were searched to identify the randomized controlledor case-controlled trials of CCRT for ESCC. A meta-analysis was performed to evaluate the efficacy and safety of CCRT for ESCC in China. Results A total of 39 randomized controlledor case controlledtrials involving 4161 patients were included in the meta-analysis. The meta-analysis showed that compared with those receiving radiotherapy alone, the ESCC patients receiving CCRT had significantly improved short-term outcomes (OR=2.588, P=0.000) and significantly increased 1-, 3-, and 5-year survival rates (HR=1.995, P=0.000;HR=2.047, P=0.000;HR=2.265, P=0.000), but they also had significantly increased incidence rates of radiation esophagitis (grade ≥3), radiation pneumonia (grade ≥2), and bone marrow suppression (grade ≥3)(OR=4.372, P=0.000;OR=1.962, P=0.005;OR=4.403, P=0.000). Among the ESCC patients receiving CCRT, those treated with paclitaxel-containing regimen had significantly improved short-term outcomes (OR=1.868, P=0.036) and similar 1-and 3-year survival rates (HR=1.087, P=0.781;HR=1.315, P=0.569), as compared with those treated with FP regimen. Conclusions CCRT can significantly improve the short-term outcome and long-term survival in ESCC patients, but it also increases the incidence of toxicities. Paclitaxel-containing regimen has better short-term efficacy than standard FP regimen among ESCC patients receiving CCRT.

Key words： Esophageal neoplasms/concomitant chemoradiotherapy Prognosis Meta analysis

收稿日期: 2013-07-03

通讯作者: 于金明,Email:yujinmingsd@yahoo.com.cn

引用本文:

王军,于金明,景绍武等. 食管鳞癌同期放化疗荟萃分析[J]. 中华放射肿瘤学杂志, 2013, 22(6): 446-449.

WANG Jun,YU Jin-ming,JING Shao-wu et al. Concurrent chemoradiotherapy for esophageal squamous cell carcinoma:a meta-analysis[J]. Chinese Journal of Radiation Oncology, 2013, 22(6): 446-449.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2013.06.007 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2013/V22/I6/446

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