Role of adjuvant chemotherapy in patients with resected non-small-cell lung cancer: Reappraisal with a meta-analysis of randomized controlled trials
Role of adjuvant chemotherapy in patients with resected non-small-cell lung cancer: Reappraisal with a meta-analysis of randomized controlled trials
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DOI：
10.1200/jco.2004.01.153
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发表时间：
2004-10-01
影响因子：
45.3
通讯作者：
Tanimoto, M
中科院分区：
文献类型：
--
作者：
Hotta, K;Matsuo, K;Tanimoto, M
目的辅助化疗在非小细胞肺癌（NSCLC）切除患者中的作用尚不明确。本研究旨在通过对相关试验进行荟萃分析，重新评估非小细胞肺癌切除术患者辅助化疗的有效性。方法：我们进行了文献检索，以确定1995年发表的一项荟萃分析后报道的试验，比较非小细胞肺癌术后接受化疗和单独接受手术的患者。估计风险比（HR）来评估辅助化疗的生存优势。结果通过文献检索确定了11项试验，共涉及5,716例患者。在这些试验中，风险比估计表明辅助化疗比单纯手术有生存优势（HR, 0.872; 95% Cl, 0.805 ~ 0.944; P = .001）。在亚组分析中，发现以顺铂为基础的化疗（HR, 0.891; 95% Cl， 0.815至0.975;P = 0.012）和替加氟和尿嘧啶单药治疗（UFT， HR, 0.799; 95% Cl， 0.668至0.957;P = 0.015）均可产生显著的生存获益。辅助化疗的毒性一般较轻。结论：这是第一个更新的荟萃分析，证明了顺铂化疗和单药UFT治疗作为辅助化疗在非小细胞肺癌切除术治疗中的重要性。虽然由于一个限制（荟萃分析是用抽象的数据进行的），结果必须仔细解释，但它们提出了在未来研究中必须解决的关键问题。(C) 2004年由美国临床肿瘤学会出版。
Purpose The role of adjuvant chemotherapy in patients with resected non-small-cell lung cancer (NSCLC) remains to be defined. This study was aimed at re-evaluating the effectiveness of adjuvant chemotherapy in patients with resected NSCLC, by performing a meta-analysis of relevant trials.Methods We performed a literature search to identify trials reported after the publication of a meta-analysis in 1995, comparing patients with NSCLC receiving chemotherapy after surgery with those undergoing surgery alone. The hazard ratio (HR) was estimated to assess the survival advantage of adjuvant chemotherapy.Results Eleven trials conducted on a total of 5,716 patients were identified by the literature Search. In these trials, hazard ratio estimates suggested that adjuvant chemotherapy yielded a survival advantage over surgery alone (HR, 0.872; 95% Cl, 0.805 to 0.944; P = .001). In a subset analysis, both cisplatin-based chemotherapy (HR, 0.891; 95% Cl, 0.815 to 0.975; P = .012) and single-agent therapy with tegafur and uracil (UFT; HR, 0.799; 95% Cl, 0.668 to 0.957; P = .015) were found to yield a significant survival benefit. The toxicities of adjuvant chemotherapy were found to be generally mild.Conclusion This is the first updated meta-analysis demonstrating the importance of cisplatin-based chemotherapy and single-agent UFT therapy as adjuvant chemotherapy in the treatment of resected NSCLC. Although the results must be carefully interpreted because of one limitation (the meta-analysis was performed with abstracted data), they raise critical issues that must be resolved in future studies. (C) 2004 by American Society of Clinical Oncology.