食管癌新辅助化疗的Meta分析

目的:用系统评价的方法对新辅助化疗治疗食管癌的疗效进行评估,从而为临床决策提供参考.方法:计算机检索PubMed,EMBASE,Cochrane Library,中国期刊全文数据库,中国生物医学文献数据库,中文科技期刊数据库等资源,搜集2010-04前发表的有关新辅助化疗治疗食管癌的随机对照试验(RCTs),按Cochrane系统评价手册5.0.2的文献质量评价办法评价纳入研究的方法学质量,而后提取有效数据并采用RevMan 5.0.17软件进行Meta分析.结果:共纳入11个随机对照试验,包括2 343例患者.Meta分析结果显示,与单纯手术性比,新辅助化疗可以提高根治切除率RR=1.12,95％CI(1.04～1.22)]和5年生存率RR=1.39,95％CI(1.15～1.68)]而两组间3年生存率RR=1.18,95％CI(0.94～1.49)]、疾病进展时间MD=0.61,95％CI(-4.87～6.10)]及术后并发症差异无统计学意义RR＝1.21,95％CI(0.83～1.76)].结论:食管癌术前进行新辅助化疗可以提高根治切除率和5年生存率,使患者受益.

Meta-analysis of neoadjuvant chemotherapy for esophageal cancer

OBJECTIVE:To compare the effectiveness and adverse of neoadjuvant chemotherapy for esophageal cancer.METHODS:PubMed,EMBASE,Cochrane Library,Chinese Biomedical Literature Database,China Journal Full Text Database were searched and references of the included studies up to April 2010.Randomized controlled trials involving neoadjvant chemotherapy plus surgery and surgery alone for esophageal cancer.Study selection,data collection and quality assessment of studies were performed by two individual reviewers according to the Cochrane Handbook for systematic reviews of interventions 5.0.2.Statistic analysis were calculated using RevMan5.0.17software.RESULTS:Eleven randomized controlled trails,a total of 2 343patients were involved.There were significant differences in resection rate 〔 RR=1.12,95%CI(1.04-1.22)〕 and 5year survival rate 〔 RR=1.39,95%CI(1.15-1.68)〕 No statistical different in 3year survival rate 〔 RR=1.18,95%CI(0.94-1.49)〕,Time to progression 〔 MD=0.61,95%CI(-4.87-6.10)〕 and complications of surgery RR=1.21,95%CI(0.83-1.76)].CONCLUSION:Neoadjuvant chemotherapy plus surgery can benefit patients by raising the R0resection rate and 5year survival rate.