Evidence from an updated meta-analysis of the prognostic impacts of postoperative radiotherapy and chemotherapy in patients with anaplastic thyroid carcinoma.
Evidence from an updated meta-analysis of the prognostic impacts of postoperative radiotherapy and chemotherapy in patients with anaplastic thyroid carcinoma.
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甲状腺未分化癌术后放疗和化疗对预后影响的最新荟萃分析证据
DOI：
10.2147/ott.s153759
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发表时间：
2018
影响因子：
4
通讯作者：
Sun C
中科院分区：
文献类型：
--
作者：
Xia Q;Wang W;Xu J;Chen X;Zhong Z;Sun C
放疗和化疗是间变性甲状腺癌（ATC）术后两种重要的治疗手段，多项研究表明，术后放疗和化疗可延长ATC患者的生存期。然而，研究结果并不一致。
为探讨术后放疗和化疗是否能延长ATC患者的生存期，进行了一项荟萃分析。
纳入相关研究，并计算合并风险比（HRs）及95%置信区间（CIs）。
本荟萃分析纳入了10项关于影响ATC预后因素的相关研究，共评估1163例患者。采用随机效应模型计算总生存期（OS）的合并HR。合并结果显示，对于所有可切除的ATC患者，与单纯手术相比，手术联合放疗显著降低了死亡风险（HR = 0.51，95%CI：0.36 - 0.73，Z = 3.66，P = 0.0002）。为研究化疗对ATC患者预后的影响，我们同样采用随机效应模型计算化疗对OS的合并HR；然而，合并结果表明，与对照组相比，化疗并未延长ATC患者的生存期（HR = 0.63，95%CI：0.33 - 1.21，Z = 1.39，P = 0.17）。
本研究提供的证据表明，目前对于ATC患者，术后放疗可能延长生存期；相反，化疗并不能改善长期生存情况。
Background Radiotherapy and chemotherapy are the two important postoperative management approaches for anaplastic thyroid carcinoma (ATC), and several studies have suggested that postoperative radiotherapy and chemotherapy can prolong the survival of patients with ATC. However, the results remain inconsistent. Objective A meta-analysis was performed to address whether postoperative radiotherapy and chemotherapy could prolong the survival of patients with ATC. Methods Relevant studies were included, and pooled hazard ratios (HRs) together with 95% confidence intervals (CIs) were calculated. Results Ten relevant studies on factors that affect the prognosis for ATC were included in this meta-analysis, evaluating a total of 1,163 patients. The pooled HR for overall survival (OS) was calculated using a random-effects model. The pooled results demonstrated that for all patients with resectable ATC, the combination of surgery and radiotherapy significantly reduced the risk of death compared with surgery alone (HR =0.51, 95% CI: 0.36–0.73, Z=3.66, P=0.0002). To investigate the prognostic impacts of chemotherapy in patients with ATC, we also calculated the pooled HR of chemotherapy for OS using a random-effects model; however, the pooled results suggested that chemotherapy did not prolong the survival of ATC patients compared with controls (HR =0.63, 95% CI: 0.33–1.21, Z=1.39, P=0.17). Conclusion This study provided evidence that currently, for patients with ATC, postoperative radiotherapy may prolong survival; in contrast, chemotherapy did not improve long-term survival.