紫杉醇联合顺铂同步放化疗治疗中晚期食管癌的Meta分析

A Meta Analysis of Concurrent Radiotherapy Plus Paclitaxel and Cisplatin in Treatment of Esophageal Cancer

目的评价紫杉醇联合顺铂同步放化疗综合治疗中晚期食管癌的临床疗效及安全性。方法计算机检索PubMed、EMBASE、Cochrane Library、CNKI等数据库,收集相关的随机对照试验(RCTs),按照入选标准,采用Rev Man 5.0统计软件进行统计学分析。结果共纳入6个随机对照试验,包括559例患者。Meta分析结果显示,与单纯放疗比,紫杉醇联合顺铂同步放化疗可提高有效率,其RR值及95%CI可信区间为1.28(1.17,1.40),1、2、3年生存率RR值及95%CI分别为1.25(1.10,1.42)、1.44(1.18,1.76)、1.46(1.15,1.86)。但不良反应也提高,如放射性食管炎、消化道不良反应,其RR值及95%CI分别为2.49(1.02,6.08)、25.00(3.49,179.25)。结论紫杉醇联合顺铂同步放化疗治疗中晚期食管癌疗效优于单纯放疗,不良反应随之增加,但大多可以耐受。

Objective To evaluate the clinical efficacy and safety of paclitaxel plus cisplatin chemotherapy combining concurrent radiotherapy on esophageal carcinoma.Methods We searched PubMed,EMBASE,Cochrane Library,CNKI,and other databases to collect randomized controlled trials（RCTs）.According to the statistical analysis of RevMan5.0 statistical software.Results The results were included in six randomized controlled trials,including 559 cases of patients.Meta analysis showed that in the treatment of advanced esophageal carcinoma,when compared with radiotherapy alone,the concurrent radiotherapy and chemotherapy can improve the efficiency,the RR value and 95% confidence interval were 1.28（1.17,1.40） and 1,2 or 3-year survival rate of RR values and 95% confidence interval are 1.25（1.10,1.42）,1.44（1.18,1.76）,1.46（1.15,1.86）,respectively.However,the toxicities also increased,such as the incidence of radioactive esophagitis and gastrointestinal adverse reactions were 2.49（1.02,6.08）,25.00（3.49,179.25）,respectively.Conclusion The efficacy of pacli taxol plus cisplatin combined with concurrent radiotherapy on esophageal carcinoma is more effective than that of concurrent radiotherapy alone.Although the adverse reactions are increased at the same time,most of them can be tolerated.