新辅助化疗对肌层浸润性膀胱癌预后影响的Meta分析樊晓栋姜庆.DOCVIP

新辅助化疗对肌层浸润性膀胱癌预后影响的Meta分析 樊晓栋，姜 庆，王家武（400016 重庆，重庆医科大学附属第二医院泌尿外科） [通信作者] 姜 庆, 电话：(023E-mail：jq001002@ [摘要] 目的 评价新辅助化疗对肌层浸润性膀胱癌患者预后的影响。 方法 通过PubMed、Cochrane library、万方、康健、CBMdisc、EMBASE等数据库收集国内外已发表的相关前瞻性随机对照研究，按预设的标准进行筛选，对纳入研究进行质量评价，并提取数据进行Meta分析。 结果 符合纳入标准的共12个研究，总样本量3286人，新辅助治疗组1636人，对照组1650人，分析结果显示新辅助化疗组与对照组相比，死亡风险优势比0.85（95%CI 0.73-0.98），P=0.03。将12个纳入研究按新辅助化疗方案进行亚组分析，单用铂剂组显示新辅助化疗并没有降低患者死亡风险，而以铂剂为基础的多药联合新辅助化疗可降低患者死亡风险（OR 0.79，95%CI 0.67-0.92，P=0.0004）。结论 新辅助化疗，尤其是以铂剂为基础的联合化疗方案，适用于肌层浸润性膀胱癌的治疗，可改善预后。 [关键词] 新辅助化疗；肌层浸润性膀胱癌；Meta分析 [中图法分类号] R694 [文献标志码] A Meta-Analysis of effect of neoadjuvant chemotherapy on prognosis of muscle-invasive bladder cancer Fan Xiaodong，Jiang Qing，Wang Jiawu(Department of Urology，The Second Affiliated Hospital of Chongqing Medical Un-iversity，Chongqing，400016，China) Abstract：Objectives To evaluate the effect of neoadjuvant chemotherapy on prognosis of muscle-invasive bladder cancer. Methods：To search and screen published prospective RCT on neoadjuvant chemotherapy for muscle-invasive bladder cancer in Pubmed，EMBASE，CBMdisc，Cochrane library and WanFang databases under preset standards. The data from eligible studies were pooled through Meta-analysis. Results：Totally 12 trials including 3286 patients were eligible to the criteria(1636 in study group and 1650 in control group).The odds radio of all trails tended to favour neoadjuvant chemotherapy (OR=0.85，95%CI 0.73-0.98，P=0.03).Platinum-based combination chemotherapy showed a significant reduc-tion in risk of death（OR 0.79, 95%CI 0.67-0.92，P=0.0004），but there was no evidence to support the use of single-agent platinum. Conclusions：Neoadjuvant chemotherapy especially platinum-based combination chemotherapy is beneficial to muscle-invasive bladder cancer patients. [Key words] neoadjuvant chemotherapy；muscle-invasive bladder cancer；Meta-analysis Corresponding author: Jiang Qing， Tel:86-23 E-mail: jq001002@ 膀胱癌是泌尿系统最常见的恶性肿瘤，在我国其发病率居泌尿系统恶性肿瘤的首位。每年新发的病例中15%