食管癌术后辅助治疗的Meta分析

目的]探讨食管癌术后辅助治疗的价值.方法]收集1995年至2011年期间发表的关于食管癌术后辅助治疗的随机对照研究文章,利用Stata12.0软件进行Meta分析.结果]与单纯手术相比,术后辅助化疗患者的3年无进展生存率相对危险度(RR)为1.225 (95％CI:1.012～1.482,P=0.037),差异有统计学意义.而3、5年总生存率的RR值分别为0.899(95％CI:0.797～1.016,P=0.087),1.183(95％CI:0.97～1.442,P=0.098),差异无统计学意义.同样,与单纯手术相比,术后辅助放疗患者的3年总生存率的RR值为0.935 (95％CI:0.879～0.994,P=0.033),差异有统计学意义.而5年总生存率的RR值为0.988(95％CI:0.821～1.188,P=0.897),差异无统计学意义.Begg's与Egger试验检测P值均大于0.05,不存在发表偏倚.结论]术后辅助化疗能延长食管癌患者术后的3年无进展生存率,术后辅助放疗不利于延长食管癌患者的3年总生存率.

A Meta Analysis of Adjuvant Therapy for Esophageal Cancer Postoperation

Purpose] To investigate the value of adjuvant therapy for esophageal cancer postoperation.Method] randomized control study articles about adjuvant treatment after esophagectomy from 1995 to 2011 were collected,and Stata12.0 software was used for Meta analysis.Reasults] Compared with patients undergoing surgery alone,the 3-year progress free survival(PFS) in patients with adjuvant chemotherapy was significantly different,with RR 1.225(95%CI:1.012～1.482,P=0.037).But 3-,5-year overall survival rates(OS) with RR 0.899(95%CI:0.797～1.016,P=0.087) and 1.183(95%CI:0.97～1.442,P=0.098),respectively.3-year OS of adjuvant radiation patients was significantly different with that of the patients with surgery alone,RR0.935(95%CI:0.879～0.994,P=0.033).But 5-year OS with RR 0.988(95%CI:0.821～1.188,P=0.897).P values of Begg’s and Egger test were greater than 0.05,indicating there was no publication bias in the study.Conclusion] Postoperative adjuvant chemotherapy can improve the 3-year PFS in patients with esophageal cancer after surgery,while postoperative adjuvant radiation does not improve 3-year OS.