文章摘要
王 黎,李丹明.放化疗治疗中晚期胰腺癌疗效的Meta分析[J].南京医科大学学报,2012,(1):129~135
放化疗治疗中晚期胰腺癌疗效的Meta分析
Meta-analysis of the efficacy of radio-chemotherapy for the middle-late stage patients with pancreatic carcinoma
投稿时间:2011-06-03  
DOI:10.7655
中文关键词: 胰腺癌  放化疗  Meta分析
英文关键词: pancreatic carcinoma  radio-chemotherapy  Meta-analysis
基金项目:
作者单位
王 黎 南京市建邺医院内科,江苏 南京 210019 
李丹明 南京医科大学第一附属医院放射治疗科,江苏 南京 210029 
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中文摘要:
      目的:评价联合放化疗在中晚期胰腺癌治疗中的疗效和安全性?方法:计算机检索MEDLINE?EMBASE?Cochrane图书馆?中国期刊全文数据库和万方数据库中的相关文献,语种不限,所有检索均截止至2011年1月1日?检索所有有关放化疗和单用放疗或化疗治疗中晚期胰腺癌的随机对照试验,由2名评价员筛选和提取资料,并用修改的Jadad量表进行质量评估,对符合纳入标准的研究采用RevMan4.2软件进行分析?结果:共纳入18个随机对照试验,17篇中文,1篇英文,总共944例中晚期胰腺癌患者?Meta分析结果显示与单用化疗或放疗治疗中晚期胰腺癌组的疗效相比,联合放化疗可以明显提高6个月及1年生存率?明显提高瘤灶显效率,并可缓解胰腺癌引起的疼痛症状,6个月及1?2?3年总生存率的相对危险度RR值(95%CI)分别为3.01(1.88~4.79)?1.97(1.48~2.63)?3.55(2.04~6.17)?3.92(1.07~14.34);瘤灶显效率和疼痛缓解率的相对危险度RR值(95%CI)分别为3.18(2.25~4.50)?2.85(1.85~4.41)?有15篇研究报道了与治疗相关的不良反应?主要为骨髓抑制反应:包括白细胞?血小板减少;胃肠道反应:恶心?呕吐?呃逆?食欲降低?消化不良?排便次数增多,胃和十二指肠黏膜糜烂?溃疡?腹泻;少量患者出现神经毒性及发热等?结论:相对于单用化疗或放疗手段治疗中晚期胰腺癌,联合放化疗可以明显提高中晚期胰腺癌总生存率?疼痛缓解率,并提高瘤灶显效率,且安全性较高,是一种较好的中晚期胰腺癌治疗方法?
英文摘要:
      Objective: To evaluate the safety and efficacy of radio-chemotherapy for middle-late stage patients with pancreatic carcinoma. Methods: MEDLINE,EMBASE,the Cochrane Library,CNKI and Wanfang Database were searched without language limitation. The end of time was at January 1st,2011. All randomized controlled trials comparing chemotherapy or radiotherapy alone with radio-chemotherapy for treating middle-late stage pancreatic carcinoma were identified and screened by two reviewers and the methodological quality of the included randomized controlled triads were evaluated by mediated Jadad scale. The RevMan4.2 software Wits was used for the analysis of the dam extracted from the included randomized controlled trials. Results: Eighteen randomized controlled trials involving 944 patients were included with 17 trials published in Chinese and 1 in English language. Meta-analysis of the data extracted from the included randomized controlled trials showed the radio-chemotherapy could significantly improve the overall survival rates compared with chemotherapy or radiotherapy alone,the corresponding relative risk(RR) values(95%CI) for the 6-month,l,2,and 3-year survival rate were 3.01(1.88~4.79),1.97(1.48~2.63),3.55(2.04~6.17)and 3.92(1.07~14.34)respectively;and the effective rate of tumor and pain relief rate were 3.18(2.25~4.50) and 2.85(1.85~4.41). Side effects of the radio-chemotherapy were reported in 15 randomized controlled trials mainly hematopoietic toxicity including leucopenia and thrombocytopenia;gastrointestinal tract effect including nausea,vomit,hiccups,loss of appetite,indigestion,the bowel movement times increasing,gastric and duodenal mucosal ulcer,diarrhea;The neuro-toxicity and fever were observed in some patients. Conclusion: The general analysis showed that compared with radiotherapy and chemotherapy alone,radio-chemotherapy could improve total survival rate for patients with late-stage pancreatic carcinoma,the catabatic rate of pain and tumor focus efficacy rate,higher safety and was a better method of treating middle-late stage pancreatic carcinoma.
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