时辰化疗联合放疗局部晚期鼻咽癌疗效<i>Meta分析</i>

doi:10.3760/cma.j.cn113030-20210531-00211

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摘要目的利用Meta分析方法评价时辰化疗联合放疗治疗局部晚期鼻咽癌的疗效、安全性。方法计算机检索The Cochrane Library (2021年5期)、Pubmed、Embase、CBM、CNKI、VIP及万方数据库,对符合纳入标准的研究进行方法学质量评价、采用RevMan5.3软件进行Meta分析。结果共纳入16个研究1275例患者,其中时辰化疗联合放疗组642例,常规化疗联合放疗组633例。结果显示时辰化疗联合放疗比常规化疗联合放疗组能提高有效率(OR=1.66,95%CI为1.17~2.34,P=0.004),降低白细胞下降、血小板下降、胃肠道反应发生率、3-4级口腔黏膜反应及放射性皮炎发生率(均P<0.001);放化疗结束后CD3、CD4、CD4/CD8细胞数也较高(均P<0.001)。结论现有证据表明时辰化疗联合放疗能提高局部晚期鼻咽癌患者近期有效率,降低不良反应,同时细胞免疫功能下降程度减少。

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	杨健筌
	郭文
	郎锦义
	卢漫

关键词 ：鼻咽肿瘤/时辰化学疗法, 鼻咽肿瘤/放射疗法, 荟萃分析

Abstract：Objective To systematically compare the efficacy and safety of chrono-chemotherapy combined with radiotherapy in patients with locally advanced nasopharyngeal carcinoma. Methods Seven databases were searched, including the Cochrane Library (Issue 5, 2021), PubMed, Embase, CBM, CNKI, VIP and Wanfang Database. The method ological quality of the eligible studies was evaluated. The Meta-analysis was performed by the Revman 5.3software. Results Sixteen studies consisting of 1275 patients were finally included. Among them, 642 patients were treated with chrono-chemotherapy combined with radiotherapy and 633 patients received conventional chemotherapy combined with radiotherapy. Results showed that compared with conventional chemotherapy group, the effective rate was significantly elevated (OR=1.66,95%CI:1.17-2.34,P=0.004), the incidence of leucopenia, thrombocytopenia, gastrointestinal reaction, grade 3-4 oral mucosal reaction and grade 3-4 radiothermitis was significantly reduced (all P<0.001), and the quantity of CD3, CD4 and CD4/CD8 was significantly increased in the chrono-chemotherapy group. Conclusion Current evidence shows that compared with conventional chemotherapy, chrono-chemotherapy combined with radiotherapy could improve the effective rate, reduce adverse reactions and mitigate the destruction of immune function simultaneously.

Key words： Nasopharyngeal neoplasm/chrono-chemotherapy Nasopharyngeal neoplasm/radiotherapy Meta-analysis

收稿日期: 2021-05-31

基金资助:国家重点研发计划(2019YFE0196700)

通讯作者: 郎锦义,Email:langyj60@163.com;卢漫,Email:graceof@163.com

引用本文:

杨健筌,郭文,郎锦义等. 时辰化疗联合放疗局部晚期鼻咽癌疗效Meta分析[J]. 中华放射肿瘤学杂志, 2022, 31(2): 120-124.

Yang Jianquan,Guo Wen,Lang Jinyi et al. Meta-analysis of chrono-chemotherapy combined with radiotherapy for locally advanced nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2022, 31(2): 120-124.

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[1] Tang LL, Chen WQ, Xue WQ, et al. Global trends in incidence and mortality of nasopharyngeal carcinoma[J]. Cancer Lett, 2016, 374(1):22-30. DOI:10.1016/j.canlet.2016.01.040.
[2] Chen YP, Chan ATC, Le QT, et al. Nasopharyngeal carcinoma[J]. Lancet, 2019, 394(10192):64-80. DOI:10.1016/S0140-6736(19)30956-0.
[3] Lee N, Xia P, Quivey JM, et al. Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma:an update of the UCSF experience[J]. Int J Radiat Oncol Biol Phys, 2002, 53(1):12-22. DOI:10.1016/s0360-3016(02)02724-4.
[4] Kong F, Cai BZ, Chen XZ, et al. Prognostic factors for survival of patients with nasopharyngeal carcinoma following conventional fractionation radiotherapy[J]. Exp Ther Med, 2013, 6(1):57-60. DOI:10.3892/etm.2013.1100.
[5] Lee AW, Tung SY, Chan AT, et al. Preliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma[J]. Int J Radiat Oncol Biol Phys, 2006, 66(1):142-151. DOI:10.1016/j.ijrobp.2006.03.054.
[6] Chen D, Cheng J, Yang K, et al. Retrospective analysis of chronomodulated chemotherapy versus conventional chemotherapy withpaclitaxel, carboplatin, and 5-
fluorouracil in patients with recurrent and/or metastatic head and neck squamous cell carcinoma[J]. Onco Targets Ther, 2013, 24(6):1507-1514. DOI:10.2147/OTT. S53098.
[7] Lévi F, Okyar A. Circadian clocks and drug delivery systems:impact and opportunities in chronotherapeutics[J]. ExpertOpin Drug Deliv, 2011, 8(12):1535-1541. DOI:10.1517/17425247.20 11.618184.
[8] 彭小东,宋来,张舰,等. 中国鼻咽癌患者时辰化疗联合放疗疗效及安全性的Meta分析[J]. 中国眼耳鼻喉科杂志,2018, 18(5):333-338. DOI:10.14166/j.issn.1671-2420.2018.05.013.
Peng Xd, Song L, Zhang J, et al. Efficacy and safety of chemotherapy combined with radiotherapy in patients with nasopharyngeal cancer:a meta-analysis[J]. Chin J Eye Otolaryngol, 2018, 18(5):333-338. DOI:10.14166/j.issn. 1671-2420.2018.05.013.
[9] 欧阳金陵. 时辰化疗对鼻咽癌患者免疫功能的影响[J]. 贵阳医学院学报,2007, 32(4):375-377. DOI:10.3969/j.issn.1000-2707.2007.04.013.
Ouyang JL. Effect of chemotherapy on immune function of patients with nasopharyngeal carcinoma[J]. J Guiyang Med Coll, 2007, 32(4):375-377. DOI:10.3969/j.issn.1000-2707.2007.04.013.
[10] 刘清壮,赵毅,王燕. 调强放疗同期顺铂时辰化疗联合西妥昔单抗对局部晚期鼻咽癌患者的影响[J]. 中国临床研究,2015, 28(5):551-555. DOI:10.13429/j.cnki.cjcr.2015.05.003.
Liu QZ, Zhao Y, Wang Y. Effect of intensity modulated radiotherapy combined with cisplatin chemotherapy combined with cetuximab in patients with locally advanced nasopharyngeal carcinoma[J]. Chin J Clin Res, 2015, 28(5):551-555. DOI:10.13429/j.carolcarrollnki CJCR. 2015.05.003.
[11] Chen YP, Wang ZX, Chen L, et al. A bayesian network meta-analysis comparing concurrent chemoradiotherapy followed by adjuvant chemotherapy, concurrent chemoradiotherapy alone and radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma[J]. Ann Oncol, 2015, 26(1):205-211. DOI:10.1093/annonc/mdu507.
[12] Li H, Fan X, Luo Y, et al. Repeated manganese aDministration produced abnormal expression of circadian clock genes in the hypothalamus and liver of rats[J]. Neurotoxicology, 2017, 62(1):39-45. DOI:10.1016/j.neuro.2017.05.007.
[13] Chen-Goodspeed M, Lee CC. Tumor suppression and circadian function[J]. J Biol Rhythms, 2007, 22(4):291-298. DOI:10.1177/0748730407303387.
[14] Liao C, Li J, Bin Q, et al. Chronomodulated chemotherapy versus conventional chemotherapy for advanced colorectal cancer:a meta-analysis of five randomized controlled trials[J]. Int J ColorectalDis, 2010, 25(3):343-350. DOI:10.1007/s00384-009-0838-4.
[15] Sun Y, Li WF, Chen NY, et al. Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma:a phase 3, multicentre, randomised controlled trial[J]. Lancet Oncol, 2016, 17(11):1509-1520. DOI:10.1016/S1470-2045(16)30410-7.
[16] 吴明玮,冼励坚,李晓梅,等. 二氢嘧啶脱氢酶、胸苷酸合成酶、c-myc和p53基因在小鼠肝组织中表达的昼夜节律性研究[J]. 癌症,2004, 23(3):235-242. DOI:10.3969/j.issn.1000-467X.2004.03.001.
Wu MW, Xian LJ, Li XM, et al. Circadian rhythm of dihydropyrimidine dehydrogenase, thymidylate synthase, C-MyC and P53 gene expression in mouse liver tissue[J]. Chin J Cancer, 2004, 23(3):235-242. DOI:10.3969/j.issn. 1000-467-x. 2004.03.001.
[17] Schroeder P, Lindemann C, Dettmar K, et al. Trifunctional antibodies induce efficient antitumour activity with immune cells from head and neck squamous cell carcinoma patients after radio-chemotherapy treatment[J]. Clin Transl Oncol, 2011, 13(12):889-898. DOI:10.1007/s12094-011-0751-5.