同步放疗联合替吉奥对比单纯放疗治疗老年食管癌Meta分析北大核心CSCD

目的应用Meta分析的方法评价同步放疗联合替吉奥(CCRT)对比单纯放疗(RT)治疗老年食管癌的疗效。方法检索Cochrane Library、Pubmed、Web of science、EMbase、CBM、CNKI、VIP、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进行Meta分析。结果共23个研究1693例患者纳入研究。结果显示,CCRT能提高完全缓解率(OR=2.08,95%CI为1.66~2.61,P<0.001)、部分缓解率(OR=1.31,95%CI为1.08~1.60,P=0.007)及总有效率(OR=2.99,95%CI为2.37~3.77,P<0.001)。同时,CCRT能提高1年生存率(OR=2.56,95%CI为1.94~3.38,P<0.001)和2年生存率(OR=2.33,95%CI为1.77~3.08,P<0.001)。不良反应方面,CCRT在白细胞降低、血小板降低、放射性食管炎、恶心和呕吐方面发生率高于对照组(P均<0.05),贫血和放射性肺炎发生率方面差异无统计学意义(P>0.05)。结论现有证据表明,同步放疗联合替吉奥能提高老年食管癌患者近期疗效,延长患者生存时间,但联合治疗会增加治疗相关的不良反应发生率。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。

Efficacy of concurrent chemoradiotherapy with S‐1 vs. radiotherapy alone for elderly patients with esophageal cancer: a meta‐analysis

Objective To evaluate the efficacy of concurrent radiotherapy combined with S‐1 (CCRT) versus radiotherapy (RT) alone in elderly patients with esophageal cancer by Meta‐analysis. Methods The Cochrane Library, PubMed, Web of science, EMbase, CBM, CNKI, VIP and Wanfang database were searched. The eligible studies were subject to evaluation of methodological quality. The Meta‐analysis was performed by the Revman 5.3 software. Results A total of 1693 patients were enrolled in 23 studies. The results showed that CCRT increased the incidence of CR OR=2.08,95%CI (1.66‐2.61), P<0.001] and PR OR=1.31,95%CI (1.08‐1.60), P=0.007] and total response rate OR=2.99,95%CI (2.37‐3.77), P<0.001]. Furthermore, CCRT improved the 1‐year survival rate OR=2.56, 95%CI (1.94‐3.38), P<0.001] and 2‐year survival rate OR=2.33, 95%CI (1.77‐3.08), P<0.001]. Meanwhile, CCRT reduced the incidence of leucopenia, thrombocytopenia, radioactive esophagitis, nausea and vomiting (all P<0.05), but there was no significant difference in the incidence of anemia and radiation pneumonia between two groups (both P>0.05). Conclusions Available evidence suggests that CCRT combined with S‐1 can improve therapeutic efficacy and prolong survival time in elderly patients with esophageal cancer, but CCRT may increase the incidence of treatment‐related side effects. Due to the limitations of the number and quality of the included studies, the above conclusions need to be verified by more high‐quality studies.