进展期胃癌新辅助化疗疗效的Meta分析

目的通过Meta分析明确新辅助化疗在进展期胃癌治疗中的价值。方法检索Cochrane Library、PubMed、Em-base、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(CSJD)、中国期刊全文数据库(CJFD)等数据库;手工检索国内、外肿瘤会议摘要及交流文献,以及中国肿瘤防治数据库有关资料,用RevMan 5.0.2软件来完成Meta分析。结果共有18项研究,2 685例患者纳入本分析,新辅助化疗组与手术组的总体生存率、5年生存率、手术切除率等方面比较,差异均有统计学意义(P<0.05),其OR值和95%可信区间(CI)分别为1.40(1.17～1.68)、1.96(1.44～2.67)、1.60(1.29～1.97),而两组的围术期病死率比较,差异无统计学意义(OR=1.06,95%CI:0.60～1.82,P>0.05)。结论进展期胃癌新辅助化疗不会增加手术风险,能够提高进展期胃癌新辅助化疗患者的手术切除率和生存率。

A Meta analysis on curative effects of neoadjuvant chemotherapy for treating advanced gastric cancer

Objective To study the value of neoadjuvant chemotherapy(NAC) for treating advanced gastric cancer by performing a Meta-analysis of the published studies.Methods Searching the data bases Cochrane libraries,PubMed,Embase,Chinese Biomedical Literature Database(CBM),Chinese Scientific Journal Full-Text Database(CSJD) and Chinese Journal Full-Text Database(CJFD),aided with manual retrieval and other retrievals,the Meta analysis was performed by using RevMan 5.0.2 software.Results Eighteen randomized controlled trials involved 2685 patients were included.Significantly statistical differences were found in the overall survival rate,5-year survival rate and the resection rate between the neoadjuvant chemotherapy group and the surgery group odds ratio(OR):1.40,95% confidence interval(CI):1.17-1.68 for the overall survival rate;OR:1.96,95% CI:1.44-2.67 for the 5-year survival rate;OR:1.60,95% CI:1.29-1.97 for the resection rate,and no statistical differences were found in perioperative mortality(OR:1.06,95% CI:0.60-1.82,P>0.05).Conclusion NAC can improve the tumor resection rate and the survival rate in the patients with advanced gastric cancer without increasing the operative risk.