术后、放疗后补充化疗在宫颈癌治疗的Meta分析

Meta-Analysis on Treatment Value of Adjuvant Chemotherapy after Operation or/and Radiation for Cervical Cancer

目的评价术后、放疗后补充化疗在宫颈癌预后中的价值。方法检索CBMdisc光盘数据库、MEDLINE数据库及Cochrane图书馆妇科肿瘤专业组数据库,筛选2002-2006年符合纳入标准的国内外公开发表的文献6篇,通过固定效应及随机效应两种模型的综合分析合并效应量,采用RevMan4.2.10统计软件分析。结果合并后的生存结果显示,术后、放疗后补充化疗组与未行补充化疗组之间生存率差异无统计学意义,优势比=0.87>0,95%可信区间0.58～1.32,P>0.05。结论Meta分析的结果说明补充化疗并不能改善宫颈癌患者的生存率,现有的循证医学证据还不足以说明补充化疗对宫颈癌预后生存的影响,需进一步开展大规模多中心的前瞻性随机试验研究。

Objective To evaluate the prognostic value of adjuvant chemotherapy after operation or/and radiation. Methods We searched for randomized trials（published from 2002 to 2006） in women with cervical cancer that compared adjuvant chemotherapy after operation or/and radiation versus surgery alone or radiotherapy alone through CBMdisc, MEDLINE, and Cochrane Gynaecological Cancer Group＇s Specialized Register CENTRAL. Results for survival were combined with fixed and random effects models. RevMan 4.2.10 software was applied to process data. Results Pooled survival rates from six randomized trials that evaluated the role of adjuvant chemotherapy after operation or/and radiation to patients with cervical cancer demonstrated no statistically significant difference compared with surgery alone or radiotherapy alone （relative risk of death, 0.87; 95% confidence interval, 0.58 to 1.32, P〉0.05 ）. Conclusions This recta-analysis confirms that treatment with adjuvant chemotherapy after operation or/and radiation can not improve overall survival versus surgery alone or radiotherapy alone in women with cervical cancer. The further studies in prospective, multicentre and randomized trials may be warranted.