Combined radiochemotherapy in patients with locally advanced pancreatic cancer: A meta-analysis
Combined radiochemotherapy in patients with locally advanced pancreatic cancer: A meta-analysis
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DOI：
10.3748/wjg.v19.i42.7461
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发表时间：
2013-11-14
影响因子：
4.3
通讯作者：
Mao, Ai-Wu
中科院分区：
文献类型：
--
作者：
Chen, Yue;Sun, Xian-Jun;Mao, Ai-Wu
目的：比较化疗加放疗（CRT）与单纯放疗（RT）或单纯化疗（CT）治疗局部晚期胰腺癌（LAPC）的长期临床疗效。方法：通过PubMed/EmBase/CNKI/CQVIP/中国期刊全文数据库以及ASCO、CSCO等主要年会的网站和会议记录，采用人工和计算机辅助的方法进行检索。采用Jadad评分系统评估纳入研究的方法学质量。检索了英文和中文出版物。我们收集了对照临床试验的数据，包括CRT与RT或CT治疗LAPC，并对15项纳入的研究进行了荟萃分析。采用RevMan4.2软件，按照Cochrane Collaboration推荐的方法进行meta分析。结果：纳入15项符合条件的随机对照试验，共纳入1128例患者。只有一篇文章的Jadad得分为2分，其余14篇研究的Jadad得分为3-4分。荟萃分析显示，CRT在6个月和12个月的生存率优于单独RT组或单独CT组（P = 0.0001和P = 0.02），而18个月生存率无显著差异（P = 0.23）。亚组分析显示，CRT组6月、12月、18月生存率与CT组无显著差异（P = 0.07、P = 0.23、P = 0.91）。CRT组6月、12月、18月生存率明显高于RT组（P < 0.01）。CRT组3-4级治疗相关血液学及非血液学毒性明显高于CT组和RT组（P < 0.01）。结论：与CT或RT相比，CRT有利于LAPC患者的长期生存，尽管它也可能增加治疗相关的毒性。（三）2013年百世登出版集团有限公司版权所有。
AIM: To compare the long-term clinical efficacy of chemotherapy plus radiotherapy (CRT) with that of radiotherapy alone (RT) or chemotherapy alone (CT) for locally advanced pancreatic carcinoma (LAPC).METHODS: Using manual and computer-aided methods, we searched the data through the databases, including PubMed/EmBase/CNKI/CQVIP/China Journals Full Text Database and websites and proceedings of major annual meetings such as ASCO and CSCO. The methodological quality of the included studies was assessed using the Jadad scoring system. Both English and Chinese publications were searched. We collected data from controlled clinical trials on CRT vs RT or CT for LAPC, and conducted a meta-analysis of 15 included studies. Meta-analysis was performed using RevMan4.2 Software according to the method recommended by Cochrane Collaboration.RESULTS: Fifteen eligible randomized controlled trials including a total of 1128 patients were screened. Jadad score was 2 in only one article, and 3-4 in the remaining 14 studies. The meta-analysis showed that CRT was superior in the 6- and 12-mo survivals to the RT alone group or CT alone group (P = 0.0001 and P = 0.02, respectively), whereas the 18-mo survival showed no significant difference (P = 0.23). Subgroup analysis showed that the 6-, 12-, and 18-mo survivals were not significantly different between the CRT group and CT group (P = 0.07, P = 0.23, and P = 0.91, respectively). Notably, the CRT group had significantly better 6-, 12-, and 18-mo survivals than the RT group (all P < 0.01). CRT group had significantly more grade 3-4 treatment-related hematologic and non-hematologic toxicities than the CT group or RT group (all P < 0.01).CONCLUSION: Compared with CT or RT, CRT can benefit the long-term survival of LAPC patients, although it may also increase treatment-related toxicities. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.