时辰化疗联合放疗局部晚期鼻咽癌疗效Meta分析

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。

Meta-analysis of chrono-chemotherapy combined with radiotherapy for locally advanced nasopharyngeal carcinoma

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.