氩氦刀治疗中晚期非小细胞肺癌的Meta分析

Effect of argon-helium cryoablation on intermediate and advanced non-small cell lung cancer:A meta-analysis

目的评价氩氦刀靶向治疗中晚期非小细胞肺癌的生存率和生活质量。方法以"肺肿瘤(Lung Cancer)、冷冻治疗(cryosurgery,cryocare surgical system,cryotherapeutic ablation,cryoablation)"为关键词检索PubMed、EMBASE、CMB光盘、《中国期刊全文数据库》、《中国生物医学文献数据库》中已发表的氩氦刀治疗中晚期NSCLC的随机临床研究,检索年限为1990-2008年,共搜集44篇。由两名评价员独立评价文献,对符合入选标准的研究用Review Manager 5.0.18软件进行Meta分析。结果共纳入5项研究。2项研究显示单纯氩氦刀靶向治疗可使瘤体缩小,但氩氦刀治疗联合放化疗并不能使瘤体进一步缩小,单纯氩氦刀治疗与氩氦刀联合放化疗对生存时间影响无统计学差异。2项研究比较患者术后KPS评分均提示单纯氩氦刀治疗优于氩氦刀联合放化疗。结论中晚期NSCLC患者单纯采用氩氦刀治疗可改善患者生活质量;而氩氦刀联合放化疗并未显示出更好的临床益处,甚至使患者生活质量下降。

Objective To assess the survival rate and life quality of patients with intermediate and advanced non-small cell lung cancer （NSCLC） after argon-helium cryoablation. Methods Forty-four papers on treatment of intermediate and advanced NSCLC with argon-helium cryoablation were searched from PubMed, EMBASE, CBMdisc, CNKI and CMCC （1990-2008） with key words ＂lung cancer＂ and ＂argon-helium cyroablation＂. The papers were evaluated by two independent reviewers. A meta-analysis was performed for those meeting the inclusion criteria using the Review Manager 5.0.18 software. Results Of the 5 papers included in this study, two reported that the tumor became smaller after argon-helium cyroablation, but did not after argon-helium cyroablation in combination with radiotherapy and chemotherapy. No difference was found in survival time after argon-helium cyroablation and argon-helium cyroablation in combination with radiotherapy and chemotherapy. The KPS score of patients was higher after argon-helium cyroablation than after argon-helium cyroablation in combination with radiotherapy and chemotherapy. Conclusion Argon-helium cyroablation can improve the life quality of patients with intermediate and advanced NSCLC, while argon-helium cyroablation in combination with radiotherapy and chemotherapy does not show any clinical advantages over argon-helium cyroablation and even decreases the life quality of such patients.