Radiotherapy for gastric cancer: a systematic review and meta-analysis
Radiotherapy for gastric cancer: a systematic review and meta-analysis
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胃癌放射治疗：系统评价和荟萃分析
DOI：
10.1007/s13277-013-1054-y
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发表时间：
2014-01-01
期刊：
影响因子：
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通讯作者：
Li, Ronghui
中科院分区：
文献类型：
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作者：
Pang, Xiaohui;Wei, Wanqing;Li, Ronghui
有许多试验试图证明胃癌放疗的益处;然而，结果要么是包容性的，要么是有争议的。本研究的目的是阐明放射治疗作为围手术期或姑息治疗对胃癌的影响。我们进行了系统的研究，探索放射治疗对胃癌的影响。在接受胃癌术前放疗的患者亚组中，发现10年总生存期有显著获益，风险比（HR）为0.75（95%置信区间（CI），0.61至0.91）;然而，5年总生存期的获益未得到证实（HR，0.68; 95% CI，0.45至1.01）。放疗组与对照组的手术切除率和根治性手术切除率也无显著性差异，相对危险度（RR）分别为1.06（95%CI，0.99 ~ 1.13）和1.12（95%CI，0.93 ~ 1.36）。在接受胃癌术后放疗的患者亚组中，3年和5年无进展生存期的生存获益分别为0.69（95%CI，0.53 - 0.90）和0.70（95%CI，0.61 - 0.80）。还发现辅助放疗对3年和5年无进展生存期的生存获益;尽管如此，3年总生存期无显著差异（HR，0.70; 95% CI，0.61 - 1.01）。放疗对5年总生存率的影响也存在争议。总之，胃癌患者无论是术前放疗还是术后放疗，都能从放疗中获益。
There have been many trials trying to prove the benefit of radiotherapy for gastric cancer; however, the results were either inclusive or controversial. The purpose of the study was to elucidate the effect of radiotherapy on gastric cancer delivered as perioperative or palliative treatment. We conducted systematic searches for trials exploring the effect of radiotherapy on gastric cancer. In the subgroup of patients receiving preoperative radiotherapy for gastric cancer, a significant benefit was found on 10-year overall survival with a hazard ratio (HR) of 0.75 (95 % confidence interval (CI), 0.61 to 0.91); however, the benefit on 5-year overall survival was not proven (HR, 0.68; 95 %CI, 0.45 to 1.01). There are also no significant differences in resection rate and radical resection rate between group of patients receiving radiotherapy and control group with a relative risk (RR) of 1.06 (95 %CI, 0.99 to 1.13) and 1.12 (95 %CI 0.93 to 1.36), respectively. In the subgroup of patients receiving postoperative radiotherapy for gastric cancer, survival benefits were found on 3- and 5-year progression-free survival with HR of 0.69 (95 %CI, 0.53 to 0.90) and HR of 0.70 (95 %CI, 0.61 to 0.80), respectively. Survival benefits of adjuvant radiotherapy on 3- and 5-year progression-free survival were also found; nonetheless, there was no evidence of significant difference in 3-year overall survival (HR, 0.70; 95 %CI, 0.61 to 1.01). The effect of radiotherapy on 5-year overall survival was also quite controversial. In short, gastric cancer patients could benefit from radiotherapy both in the form of preoperative radiotherapy and postoperative radiotherapy.