鼻窦癌术前放疗和术后放疗5年生存率的临床证据

Systematic Assessment of the Treatment of cancer of Nasal Sinus

目的评价术前放疗(RS)和术后放疗(SR)在鼻窦癌治疗中的疗效。方法对Medline,Embase,Cochrane临床对照实验资料库(CCTR)和中国生物医学文摘数据库(CBM)等4个数据库进行了机检并查阅了合格文章的参考文献,从中筛选出合格的临床文献。在本研究中由3位研究者独立评估实验质量和提取数据。选择研究对象为鼻窦恶性肿瘤的患者,实验组采用先放疗后手术治疗,对照组采用先手术后放疗治疗,比较两组治疗后5年生存率的随机对照实验。结果共筛选出8篇文章,1016例患者符合纳入标准进行研究。总的方法学质量较高。在对不同分期术前放疗与术后放疗的比较中做了3个Meta分析,其中T2T3期P>0.05,不能说明术前放疗的疗效比术后放疗的疗效好,T4期P=0.0003,说明术前放疗的疗效比术后放疗的疗效好。不同部位术前放疗与术后放疗的比较中做了2个Meta分析,上颌窦和其他窦的P均大于0.05,也不能说明术前放疗的疗效比术后放疗的疗效好。不同病理分型术前放疗与术后放疗的比较分析做了1个Meta分析,P>0.05,不能说明术前放疗的疗效比术后放疗的疗效好。结论只有上颌窦癌T4期,术前放疗的疗效要优于术后放疗的疗效。而在其他的比较中所得出的结果均不能说明术前放疗的疗效优于术后放疗的疗效。

Objective： To review the efficacy of radiotherapy before or after operation respectively in the treatment of cancers of nasal sinuses. Methods： All data by computer in Medline, Embase, Cochrane - CCTR and CBM were serrched and the references used in the qualified papers were consulted. There are 3 participator who independently evaluated the quality of the experiments and the data were collected. Selection criteria： Randomized, controlled trials, In which participants with nasal sinus cancer, comparing RS to SR on 5 - years survial rate. Results： Eight experiments and 1016 patients accorded with the criteria of study were evaluated. The review showed that only patients with T4 maxilla sinus cancer in RS group had better effect of the treatment compared to the patients in SR group. No conclusion could be drawn that the results from treatment of patients in RS group was better than that in SR group.