紫杉醇类联合铂类与顺铂联合氟尿嘧啶同期放疗治疗食管癌疗效与毒副作用比较的Meta分析

目的:系统评价紫杉醇类联合铂类（PTX类联合）方案与顺铂联合氟尿嘧啶（PF）同期放疗治疗食管癌的疗效及毒副作用。方法:两位研究者通过计算机检索PubMed、EMbase数据库，独立地对符合纳入标准的研究进行质量评价和资料提取，并用Reman5.3软件对数据进行队列研究Meta分析。疾病控制率、3年总生存率（OS）、无疾病生存率（DFS）作为主要研究终点，并进行血液毒性、胃肠道反应、放射性肺部并发症及放射性食道炎相关毒副作用比较。结果:共纳入5个研究，783例患者，PTX类联合组387例，PF组396例，5个研究为回顾性队列研究。分析表明:同期放化疗所致毒副作用两组之间无统计学差异。PTX类联合组疾病控制率高于PF组［OR=2.14，95%CI （0.86，5.33）］；PTX类联合组3年OS高于PF组［OR=1.79，95%CI （1.29，2.48）］；PTX类联合组3年DFS高于PF组［OR=1.92，95%CI （1.00，3.71）］。结论:PTX联合方案组与PF组相比，同期放化疗毒副作用相当，疾病控制率与3年OS、DFS均较好。因此PTX联合化疗方案较PF方案同期放疗治疗食管癌有较好的疗效且不增加放化疗毒副作用。

A Meta-analysis of the efficacy and adverse effects of paclitaxel plus platinum compare with cisplatin plus 5-Fluorouracil in concurrent radiotherapy for esophageal carcinoma

Objective:The efficacy and adverse effects of paclitaxel plus platinum (PTX) and cisplatin plus 5-fluorouracil (PF) in concurrent radiotherapy for esophageal carcinoma was systematically reviewed.Methods:Two researchers did computer-based retrieval with PubMed and EMbase database，independently assessed the quality of the research that conformed to the inclusion criteria and extracted the data，and used the Reman5.3 software to conduct a Meta-analysis of the cohort study.Disease control rate，3-year overall survival (OS)，disease-free survival (DFS)were taken as the main endpoint of the study，and the compared adverse effects related to blood toxicity，gastrointestinal response，radiation pulmonary complications and radiation esophagitis.Results:A total of 5 studies were included，783 patients consist of 387 cases of PTX group and 396 cases of PF group.5 studies for retrospective cohort studies.The results showed that there was no statistical difference between the two groups in adverse effects.The disease control rate，3-year OS，3-year DFS of PTX group were higher than that of PF group［odds ratio（OR）=2.14，95%CI （0.86，5.33）］,［OR=1.79，95%CI （1.29，2.48）］,［OR=1.92，95%CI （1.00，3.71）］.Conclusion:PTX group and PF group were of similar adverse-effect in concurrent chemoradiotherapy，and PTX group had better control rate of disease，3-year OS，3-year PFS and 3-year DFS.Therefore，compared with PF regimen，PTX combined chemotherapy regimen received better efficacy in concurrent radiotherapy for esophageal cancer without increasing the adverse effects of chemoradiotherapy.