中晚期鼻咽癌同期放化疗疗效的Meta分析

The efficacy of concurrent chemoradiotherapy for treatment of locally advanced nasopharyngeal carcinoma(NPC) in Chinese population:a Meta-analysis study

目的:评价中国同期放化疗中晚期鼻咽癌临床疗效和毒副反应。方法:应用Meta分析对中国同期放化疗治疗中晚期鼻咽癌临床试验进行综合评价。结果:治疗中晚期鼻咽癌,同期放化疗与常规放疗相比,减少远处转移率,其OR值为0.44(0.32-0.61);提高了1、3、5年生存率,其OR值分别为2.00(1.28-3.14)、2.31(1.83-2.92)、2.37(1.80-3.12)。白细胞减少、胃肠道反应、口腔黏膜反应的3/4度毒副反应率明显提高,分别是单纯放疗的10.27倍(2.38-44.32)、6.34倍(2.67-15.04)与2.06倍(1.28-3.31)。结论:同期放化疗治疗中晚期鼻咽癌临床疗效优于常规放射治疗,值得在临床上推广应用,但需注意毒副反应。

Objective： To evaluate the efficacy and toxicity of concurrent chemoradiotherapy for the treatment of locally advanced nasopharyngeal carcinoma （NPC） in Chinese population. Methods： Meta analysis method was used to analyze the comparative efficacy and toxicity of concurrent chemoradiotherapy versus radiotherapy alone for treatment of localy advanced nasopharyngeal carcinoma （NPC） in Chinese population. Results： Compared with radiotherapy alone, the results showed that the concurrent chemoradiotherapy decreased distant metastasis rate, and the OR was 0.44 （95%CI 0.32-0.61）; the concurrent chemoradiotherapy increased lyear, 3year and 5year survival rate, and the OR was 2.00 （95%CI 1.28-3.14）, 2.31 （95%CI 1. 83-2.92） and 2.37 （95%CI 1.80-3.12）, respectively. Meanwhile, the concurrent chemoradiotherapy increased the risk for grade 3/4 leukemia 10.27 fold （95%CI 2.38-44.32）, gastrointestinal effects 6.34 fold （95%CI 2.67-15.04） and oral mucositis 2.06 fold （95%CI 1.28-3.31）, respectively. Conclusion： The clinical efficiency of concurrent chemoradiotherapy is superior to the radiotherapy alone. It is worth to generalize in clinics but should pay attention to its toxieity.