Does Neoadjuvant Chemotherapy Increase Optimal Cytoreduction Rate in Advanced Ovarian Cancer? Meta-Analysis of 21 Studies
Does Neoadjuvant Chemotherapy Increase Optimal Cytoreduction Rate in Advanced Ovarian Cancer? Meta-Analysis of 21 Studies
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DOI：
10.1245/s10434-009-0558-6
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发表时间：
2009-08-01
影响因子：
3.7
通讯作者：
Nam, Byung-Ho
中科院分区：
文献类型：
--
作者：
Kang, Sokbom;Nam, Byung-Ho
本研究的目的是使用随机效应模型分析晚期上皮性卵巢癌（EOC）新辅助化疗（NAC）的现有数据，并确定NAC是否可以提高最佳细胞减灭率。在1989年至2008年期间，通过MEDLINE搜索检索到21项研究的数据。基于随机效应模型的荟萃回归分析评估临床变量的预后价值。接受 NAC 的患者比条件良好的患者发生次优细胞减灭术的风险较低（合并比值比，0.50；95% 置信区间，0.29-0.86；DerSimonian-Laird 模型 P = 0.012）。荟萃回归分析显示，发表年份、紫杉烷使用和最佳细胞减灭率的异质性显着影响中位总生存期（分别为 P = 0.002、P = 0.007 和 P = 0.012）。然而，NAC 周期数的研究间差异并不影响生存率 (P = 0.701)。当前的荟萃分析表明，NAC 帮助妇科肿瘤学家实现了最佳细胞减灭率的提高。
The purpose of the current study is to analyze the existing data regarding neoadjuvant chemotherapy (NAC) in advanced epithelial ovarian cancer (EOC) using a random-effects model and to determine whether NAC can improve the rate of optimal cytoreduction.Between 1989 and 2008, data of 21 studies were retrieved via a MEDLINE search. Meta-regression analysis based on a random-effects model was performed to assess the prognostic value of clinical variables.The patients who received NAC had a lower risk of suboptimal cytoreduction than the patients with favorable conditions (pooled odds ratio, 0.50; 95% confidence interval, 0.29-0.86; P = 0.012 with DerSimonian-Laird model). Meta-regression analysis revealed that heterogeneity in year of publication, taxane use, and optimal cytoreduction rate influenced median overall survival significantly (P = 0.002, P = 0.007, and P = 0.012, respectively). However, the between-studies variation of the number of NAC cycles did not influence survival (P = 0.701).The current meta-analysis showed that NAC helped the gynecologic oncologist achieve an increased rate of optimal cytoreduction.