术前化疗对Ⅲ期非小细胞肺癌患者生存的影响

目的用Meta分析方法对国内外已发表的高质量的有关术前辅助化疗对NSCLC患者术后生存期影响的随机对照试验进行综合定量分析,确定该辅助化疗对患者生存期的影响,为非小细胞肺癌外科治疗中是否采用术前化疗处理模式的选择提供参考依据。方法收集已公开发表的有关比较术前化疗加手术治疗和仅进行手术治疗对Ⅲ期非小细胞肺癌患者术后生存期影响的所有临床研究,对检索到的原始研究的质量进行评估,对符合条件的所有研究结果进行Meta分析,计算术前化疗组相对于术前未化疗组死亡危险的OR,评价术前辅助化疗对患者生存期的影响。结果符合纳入标准的共5篇文献,总样本量1238例。其中术前化疗组631例,术后3年死亡279例,术后5年死亡421例;术前未化疗组607例,术后3年死亡336例,术后5年死亡450例;术后3年合并OR=0.62,95%可信区间是（0.49,0.78）,术后5年合并OR=0.69,95%可信区间是（0.53,0.88）。结论与仅进行外科手术相比,术前化疗可以延长患者的生存期。

Effectiveness of preoperative chemotherapy on postoperative survival in patients with stage Ⅲ non-small cell lung cancer

Objective To search all randomized controlled trials studies that have been published in the world about the efficacy of preoperative chemotherapy on postoperative survival in patients with non-small-cell lung cancer （NSCLC） and analyze those high quality trials by meta-analysis,in order to give some evidences for the use of preoperative chemotherapy in surgery.Methods Evaluate strictly all the studies that have been searched, adopt the studies in high quality and then analyze them by meta-analysis.Calculate the odds ratio （OR） for death between the patients with preoperative chemotherapy and the patients in surgery alone group.Evaluate the effectiveness of preoperative chemotherapy on survival in patients with stage Ⅲ non-small cell lung cancer.Results Total 5 studies including 1238 cases were analyzed. Patients in preoperative chemotherapy group were 631, in which 279 cases were dead within 3 years after surgery,and 450 within 5 years after surgery;while in surgery alone group the cases were 607,336 and 450 respectively.The pooled OR of 3-year survival was 0.62,95% confidence interval （0.49,0.78）, and the pooled OR of 5-year survival was 0.69,95% confidence interval （0.53, 0.88）.Conclusion Preoperative chemotherapy could give some benefit for survival to patients with stage Ⅲ non-small cell lung cancer, compared with those surgery alone.