新辅助化疗治疗晚期卵巢癌的Meta分析

Neoadjuvant Chemotherapy for Advanced Ovarian Cancer:A Meta-Analysis

目的:评价新辅助化疗对晚期卵巢癌患者手术及预后的影响,探讨新辅助化疗在晚期卵巢癌中的应用。方法:计算机检索Pubmed、Cochrane Library、Embase,检索时限为1990年1月1日至2014年8月31日,纳入新辅助化疗后行间歇型肿瘤细胞减灭术与初始肿瘤细胞减灭术相比较的随机对照实验或观察性研究。结果:最终纳入20个研究,共3827例患者。Meta分析结果示:新辅助化疗后间歇型肿瘤细胞减灭术满意缩瘤术率(75.1%)高于初始肿瘤细胞减灭术(59.7%),差异有统计学意义(P<0.00001);两组无进展生存期分别为15.2月、13.0月,总生存期分别为33.2月、38.7月,差异均无统计学意义(P>0.05)。结论:新辅助化疗可以显著提高晚期卵巢癌患者肿瘤细胞减灭术满意缩瘤术的几率,但不改善无进展生存期与总生存期。

Objective：To evaluate the influence of neoadjuvant chemotherapy on surgery and prognosis in pa- tients with advanced ovarian cancer and investigate the application of neoadjuvant chemotherapy in advanced ovarian cancer. Methods ：We searched pubmed, Cochrane Library and Embase database from January 1,1990 to August 31,2014. The randomized controlled trials and observed studies were included,and meta-analysis was processed by Revman 5.3. Results ：Totally 20 articles involving 3827 patients were included. The percentage of optimal debulking surgery was statistically significantly higher in neoadjuvant chemotherapy than in primary sur- gery（75. 1% vs 59. 7%, P 〈0. 00001 ）. No difference was observed in progression-free survival（15.2 months vs 13.0 months,P〉0.05） nor overall survival（33. 2 months versus 38. 7 months, P〉0. 05） between two groups. Conclusions.The current meta-analysis showed that neoadjuvant chemotherapy increased the opportunity of optimal debulking surgery and provided equal survival compared with primary debulking surgery.