| 胃癌术后单纯化疗与放化疗联合治疗随机对照试验的Meta分析 |
| Alternative Title | Randomized controlled trial Postoperative Chemoradiotherapy versus Chemotherapy alone in patients with Gastric Cancer：a meta-analysis
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| 李小奇 |
| Thesis Advisor | 关泉林
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| 2015-05-26
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 胃癌
放射治疗
化学疗法
放化疗联合
随机对照试验
Meta分析
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| Abstract | 目的：采用循证医学Meta分析的方法分析胃癌术后放化疗联合与单纯化疗的随机对照试验的结果差异，评价其有效性及安全性。
方法：检索中国期刊全文数据库（CNKI）、维普数据库（VIP）、中国生物医学文献数据库（CBM）；Cochrane图书馆、PubMed和EMBASE（检索截至日期为2014年6月），纳入有关胃癌术后放疗联合化疗及单纯化疗的随机对照试验(RCT)，并对所纳入的文献进行质量评价，收集文献内数据，采用RevMan5.2和Stata 12.0软件进行分析评价。比较两组1、2、3年生存率；3、5年疾病无进展生存期（PFS），5年总生存率（OS），以及治疗出现的中重度胃肠道反应，骨髓抑制，手足综合征等不良反应指标。
结果：最终纳入11个RCT，共包括1143例患者，均为术后放化疗联合与单纯化疗的随机对照试验。Meta分析结果显示:1.进展期胃癌术后放化疗联合较之单纯化疗1年生存率[RR=1.20(95%CI:1.10～1.30)]、2年生存率[RR=1.34(95%CI:1.16～1.56)]、3年生存率[RR=1.57(95%CI:1.27～1.86)]、3年疾病无进展生存率[RR=1.10(95%CI:1.00～1.21)]，5年疾病无进展生存率[RR=1.27(95%CI:1.02～1.60)]及5年总生存率[RR=1.24(95%CI:1.01～1.51)]差异均存在统计学意义，对胃癌D2淋巴结清扫术后进行亚组分析，在生存期差异与整体相似；2.两组在Ⅲ～Ⅳ度白细胞减低发生[RR=1.24 (95%CI:1.02～1.50)]差异存在统计学意义，但在其他不良反应中如：Ⅲ～Ⅳ血红蛋白减低，血小板减低，胃肠道反应，手足综合征等发生率相似，差异并没有统计学意义。
结论: 胃癌术后放化疗联合辅助治疗较之单纯化疗在提高胃癌患者的生存时间获益更为明显，且与放化疗相关的不良反应未明显增加，患者耐受依存性尚可。 |
| Other Abstract | Purpose:The objective of the present meta-analysis was to analyze efficacy and safety of postoperative chemoradiotherapy after surgery for gastric cacer ,and establish a consensus on whether it is suitable for the patients.
Methods:We searched Chinese Journal Full-text database retrieval, VIP database, Chinese Biomedical Literature Database; Cochrane Library, PubMed and EMBASE (retrieved as of the date of June 2014), in relevant Gastric Cancer postoperative radiotherapy combined with chemotherapy and chemotherapy alone in randomized controlled trials (randomized controlled trial RCT), the evaluation of the methodological quality of the included studies, summarizing data using RevMan5.2 and Stata 12.0 software for analysis and evaluation. 3-year survival rates were compared; 3,5 years of disease progression-free survival (Progression-free survival PFS), 5-year overall survival (Overall survival OS), and treatment-related gastrointestinal reactions, bone marrow suppression , hand-foot syndrome and other adverse reactions indicators.
Results: A total of 1143 patients from 11 randomized controlled trials were identified for this meta-analysis. Our results showed that postoperative chemoradiothrapy can improved in1-year Survival[RR=1.20(95%CI:1.10～1.30)], 2-years Survival [RR=1.34(95% CI:1.16～1.56)], 3-years Survival [RR=1.57(95%CI:1.27～1.86)]and 3-years DFS [RR=1.10 (95%CI:1.00～1.21)],5- years DFS [RR= 1.27(95%CI:1.02～1.60)],5- years OS[RR= 1.24(95%CI:1.01~1.51)]. The main grade 3 or 4 toxicities in Nausea , Anorexia, Hand-foot syndrome and Myelosuppression were equivalent between the two groups.
Conclusion: From the results of our study ,In resected gastric cancer adjuvant Chemoradiotherapy Improve survival in gastric cancer patients benefit more obvious, and with chemotherapy-related adverse events did not significantly increased. |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/222571
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
李小奇. 胃癌术后单纯化疗与放化疗联合治疗随机对照试验的Meta分析[D]. 兰州. 兰州大学,2015.
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