氩氦刀联合放化疗方案治疗中晚期非小细胞肺癌的Meta分析

目的 评价氩氦刀联合放化疗治疗中晚期非小细胞肺癌（NSCLC）的有效性和安全性。方法 计算机全面检索The Cochrane Library、Pub Med、EMBASE、中国生物医学文献数据库、中国期刊全文数据库、维普中文科技期刊全文数据库和万方数字化期刊全文数据库中有关氩氦刀联合放化疗对比放化疗或单一疗法治疗中晚期NSCLC的随机对照试验（randomized controlled trials,RCTs）和对照试验,时间截止2014年7月16日。由2位研究者逐篇评价纳入研究的质量、提取数据并交叉核对,采用Rev Man 5.2软件进行数据处理。结果 共纳入6篇RCTs和10篇对照试验,共1 727例患者。Meta分析结果显示,与单纯氩氦刀方案比较,氩氦刀联合化疗方案在近期疗效和1、2、3年总体生存率上差异无统计学意义（P〉0.05）;与单纯化疗比较,氩氦刀联合化疗能提高中晚期NSCLC患者的近期疗效和临床受益率（OR=3.02,95%CI：1.91-4.77,P〈0.00001;OR=3.18,95%CI：1.72-5.89,P=0.0002）,可以提高中晚期NSCLC患者的1、2年总体生存率（OR=1.99,95%CI：1.23-3.20,P=0.005;OR=27.89,95%CI：1.57-494.62,P=0.02）;与单纯氩氦刀比较,氩氦刀联合放疗方案能有效提高中晚期NSCLC患者1年的总体生存率（OR=1.77,95%CI：1.03-3.06,P=0.04）;与放化疗方案比较,氩氦刀联合放化疗方案能使患者的生存质量得到改善（OR=3.34,95%CI：1.53-7.29,P=0.002）。结论 与单纯化疗比较,氩氦刀联合化疗能提高有效性并且安全性较好。与单纯氩氦刀比较,氩氦刀联合放疗能提高有效性。与放化疗比较,氩氦刀联合放化疗能改善患者的生活质量。

Argon helium knife combined with radiotherapy or chemotherapy in treatment of advanced NSCLC:A meta analysis

Objective: To evaluate the efficacy and safety of argon helium knife (AHF) combined with radiotherapy and/or chemotherapy in treatment of advanced non-small-cell lung cancer (NSCLC). Methods: Relevant randomized controlled trials (RCTs) and controlled trials (CTs) were obtained from The Cochrane Library, PubMed, EMBASE, CBM, CNKI, VIP and Wanfang databases. RCTs and CTs of AHF combined with radiotherapy and/or chemotherapy for advanced NSCLC before July 16th, 2014, were included. The quality of studies was assessed. Data were extracted and cross-checked by researchers independently. Meta-analysis was conducted by using the Cochrane Collaboration RevMan 5.2 software. Results: Six RCTs and 10 CTs involving 1 727 patients were included. Meta-analysis showed that there was no significant difference in short-term effect and 1, 2, 3-year survival rates between patients treated with AHF alone and those with AHF plus chemotherapy(all P>0.05). Compared to chemotherapy alone, AHF with chemotherapy improved short-term effect and clinical benefit rate (OR=3.02, 95% CI: 1.91~4.77, P<0.00001; OR=3.18, 95% CI: 1.72~5.89, P=0.0002), and also improved 1, 2-year overall survival rates of NSCLC patients(OR=1.99, 95% CI: 1.23~3.20, P=0.005; OR=27.89, 95% CI: 1.57~494.62, P=0.02). Compared to AHF treatment alone, AHF with radiotherapy improved 1-year overall survival rate (OR=1.77, 95% CI: 1.03~3.06, P=0.04). Compared with chemotherapy plus radiotherapy, AHF combined with chemotherapy and radiotherapy improved survival quality (OR=3.34, 95% CI: 1.53~7.29, P=0.002). Conclusion: Argon helium knife combined with radiotherapy or chemotherapy can improve the therapeutic effect for advance NSCLC patients. ©, 2015, Journal of Practical Oncology, Editorial Board. All right reserved.