摘要
目的:对Ⅱ/Ⅲ期直肠癌术前短程放疗(short-course preoperative radio-therapy,SCRT)与术前常规放化疗(preoperative chemo-radiotherapy,CRT)临床随机对照研究进行 Meta 分析,比较两种方案疗效及毒性反应。方法通过计算机检索 Pubmed、EMbase、Cochrane Library、中国期刊全文数据库、万方数据库和中文科技期刊数据库,收集Ⅱ/Ⅲ期直肠癌术前短程放疗与术前常规放化疗临床随机对照研究的文献,采用 RevMan 5.3软件进行 Meta 分析。结果收集到两项临床随机对照研究,Meta 分析结果显示:SCRT 组 T 分期降期率低于 CRT 组(RR =0.64,95%CI:0.53~0.77,P <0.05),SCRT 组病理完全反应率低于 CRT 组(RR =0.06,95%CI:0.02~0.19,P <0.05),两方案保肛率、局部复发率、总生存率及晚期严重毒性反应发生率差异均无统计学意义。结论Ⅱ/Ⅲ期直肠癌术前常规放化疗较术前短程放疗提高了 T 分期降期及病理完全反应率。
Objective To compare the therapeutic effect and toxic reaction between preoperative short-course radiotherapy(SCRT)and preoperative chemo-radiotherapy(CRT)for stage Ⅱ or Ⅲ rectal cancer.Meth-ods Original articles were searched in the Pubmed,EMbase,Cochrane Library,China Journal Full-text Data-base,Wanfang Database and Chinese sci-tech periodical full-text database.Randomized controlled trials compa-ring preoperative short-course radiotherapy and preoperative chemo-radiotherapy for stage Ⅱ or Ⅲ rectal cancer in accordance with the inclusion and exclusion criteria were included.Data extracted from these trials were ana-lyzed by the software named as RevMan 5.3.Results A total of 2 randomized controlled trials were included. The results of Meta-analysis showed that the SCRT group is less than CRT group in T downstage rate(RR =0.64,95%CI:0.53 -0.77,P 〈0.05),and pathological complete response rate(RR =0.06,95%CI:0.02 -0.19,P 〈0.05).There was no significant difference in the rate of sphincter preservation,local recurrence rate, overall survival rate and severe late toxicity rate between the two groups.Conclusions As compared with pre-operative SCRT,CRT can improve the T downstage rate and complete pathologic response rate for stage Ⅱ or Ⅲrectal cancer.
出处
《中国肿瘤外科杂志》
CAS
2014年第6期367-371,共5页
Chinese Journal of Surgical Oncology
关键词
直肠癌
术前短程放疗
术前放化疗
META
分析
rectal cancer
preoperative short-course radiotherapy
preoperative chemo-radiotherapy
Meta-analysis