新辅助化疗加手术治疗局部晚期宫颈癌的Meta分析

目的 评价新辅助化疗治疗局部晚期宫颈癌的临床疗效.方法 电子检索Cochrane图书馆、MEDLINE、EMBASE、PubMed、CBMdisc数据库,收集符合纳入标准的文献,提取资料、评价纳入研究的方法学质量,并提取有效数据进行Meta分析.结果 符合纳入标准共5篇文章,4篇为前瞻性随机对照试验,1篇为回顾性病例对照研究.新辅助化疗对局部晚期宫颈癌的5年生存率没有影响(相对危险度1.07,95％可信区间0.88～1.29,P=0.51),但提高了局部晚期宫颈癌的5年无瘤生存率(相对危险度1.13,95％可信区间1.0～1.27,P=0.01)；降低了术后淋巴结转移率及宫旁浸润率(相对危险度0.48,95％可信区间0.34～0.7,P＜0.000 1；相对危险度0.54,95％可信区间0.36～0.83,P＜0.001).结论 新辅助化疗可用于治疗局部晚期宫颈癌,可降低术后宫旁浸润率及淋巴结转移率.但纳入的研究少且都为小样本的研究,因此新辅助化疗对局部晚期宫颈癌的疗效有待进一步大样本、高质量、多中心、随机双盲对照试验加以证实.

Meta Analysis on Neoadjuvant Chemotherapy with Radical Surgery in Locally Advanced Cervical Cancer

Objective To evaluate the clinical efficacy of neoadjuvant chemotherapy （NACT） and radical surgery （RS） in locally advanced cervical cancer. Methods The following electronic databases were searched： CBMdise, MEDLNE, PubMed, EMBASE, Cochrane Library. All eligible documents were assessed for quality, and extracted data were performed by a meta-analysis. Results 5 articles met the inclusion criteria, among which were four prospective randomized controlled trials and one retrospective case-control study. NACT and RS did not increase the 5-year survival rate, but increased the 5-year disease-free survival rate and decreased lymph node metastasis and parameter metastasis. Conclusion NACT and RS could be chosen to treat the locally advanced cervical cancer. It increased the 5-year disease-free survival rate and decreased lymph node metastasis and parameter metastasis. But the conclusion is needed to be further assessed by rigorously designed, randomized, double-blind, controlled trials.