同步放化疗与放疗对早期子宫颈癌手术患者生存率的影响

The effect of adjuvant chemoradiotherapy or radiotherapy on the survival rate of patients with cervical cancer

目的评价同步放化疗与放疗对早期宫颈癌手术患者生存率的影响。方法检索公开发表的比较早期宫颈癌患者同步放化疗与放疗对生存率影响的临床研究文献,对其按meta分析的要求进行质量评估,并采用Stata 9.0软件进行统计学分析。结果共8篇文献符合纳入标准,总样本量1535例,其中同步放化疗组812例,死亡146例;放疗组723例,死亡222例。采用固定效应模型合并效应量,相对危险度(RR)=0.64(95%CI:0.53～0.78)。亚组分析显示,术前或术后同步放化疗对生存率影响比较,差异无统计学意义(P>0.05)。敏感性分析显示,本研究结果真实可靠。结论与放疗相比,同步放化疗能够显著改善早期宫颈癌手术患者的生存率。

Objeciive To evaluate the effect of adjuvant chemoradiotherapy and radiotherapy on the survival rate of patients with cervical cancer. Methods We searched the studies which comparing the effect of chemoradiotherapy or radio- therapy on the survival rate of patients with cervical cancer, and evaluate the quality of the studies. All the data was ana- lyzed with the assistance of Stata 9.0 software. Results 8 studies including 1 535 cases met the inclusion criteria. The cu- mulative cases in chemoradiotherapy group were 812, in which 146 cases were dead; while in radiotherapy group there were 723 eases and 222 death. The pooled RR was 0. 64, with a 95% confidence interval 0.53-0.78. Sub- group analysis showed that chemoradiotherapy before or after surgery has no statistical difference with the overall survival rate （P〉 0. 05）. Sensitivity analysis showed that the result was stable. Conclusion For operable patients with early stage cervical cancer, chemoradiotherapy has a better overall survival rate than radiotherapy alone.