放, 化疗治疗局部晚期鼻咽癌的Meta 分析.docVIP

放、化疗治疗局部晚期鼻咽癌的Meta分析 张岸梅，陈正堂( （第三军医大学附属新桥医院 全军肿瘤研究所） 摘 要：目的 比较放、化疗综合治疗与单纯放疗在局部晚期鼻咽癌（nasopharyngeal carcinoma，NPC）患者中的疗效，分析两者在死亡率（mortality rate, MR）、无事件生存率（event-free survival，EFS）、局部复发率（locoregional recurrence rate，LRR）及远处转移率（distant metastasis rate，DMR）的差别，以进一步明确放、化疗综合治疗在局部晚期鼻咽癌中的作用。方法 根据制定的文献纳入标准，选择已发表的临床随机对照研究进行Meta分析。结果 本研究共纳入16项临床研究，累计3768例患者。同期放、化疗组患者的2、3和5年MR、EFR、LRR及DMR均较单纯放疗组显著改善。与单纯放疗组相比，诱导化疗组的LRR及DMR亦较低。而辅助化疗与单纯放疗相比，OS、EFR、LRR和DMR都没有明显的统计学差异。结论 放、化疗综合治疗（尤其是同期放、化疗）与单纯放疗相比，能更好的改善鼻咽癌患者的生存率，并降低鼻咽癌的局部复发率和远处转移率，是治疗局部晚期鼻咽癌患者的有效方法。 关键词：鼻咽肿瘤；放疗；化疗；荟萃分析；随机对照试验 中图法分类号：R739.6 文献标识码：A Adding Chemotherapy to Radiotherapy for Nasopharyngeal Cancer: A Meta-Analysis of Randomized Controlled Trial ZHANG An-mei，CHENG Zheng-tang （Institute of Cancer Research, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.） Abstract：Objective To compare the beneficial effect achieved by adding chemotherapy to radiotherapy with radiotherapy alone for locally advanced nasopharyngeal carcinoma. Method A systematic review of all randomized controlled trials (RCT) comparing adding chemotherapy to radiotherapy with radiotherapy alone was performed. Results 16 trials involving 3768 patients were included. Our results showed that: (1) Mortality rate (MR), event-free survival (EFS), loco-regional control rate (LRR) and distant control rate (DMR) were all improved in patients receiving concomitant chemotherapy;.(2) Induction chemotherapy also can improve loco-regional control rate and distant control rate of patients with nasopharyngeal carcinoma when compared with radiotherapy alone;.(3) There was no difference between adjunctive chemotherapy and radiotherapy alone in MR, EFS, LRR and DMR. Conclusions It can be concluded that adding chemotherapy to radiotherapy could improve survival and EFS of patients with nasopharyngeal carcinoma. It also reduced LRR and DMR of these patients when compared with radiotherapy alone. We believed that adding chemot