同期放化疗治疗中晚期鼻咽癌治疗效果的Meta分析

Meta analysis of concurrent chemoradiotherapy in the treatment of intermediate and advanced nasopharyngeal carcinoma

目的探讨同期放化疗治疗中晚期鼻咽癌疗效的Meta分析。方法检索、筛选文献,评价文献质量,提取数据,进行统计学分析探讨同期放化疗治疗中晚期鼻咽癌的疗效。结果 10篇提供1年生存率,异质性分析P=0.75,治疗组患者的1年生存率显著高于对照组患者,差异有统计学意义(P<0.05)。14篇提供3年生存率,异质性分析P=0.99,治疗组患者的3年生存率显著高于对照组患者,差异有统计学意义(P<0.05)。8篇提供5年生存率,异质性分析P=0.74,治疗组患者的5年生存率显著高于对照组患者,差异有统计学意义(P<0.05)。7篇提供远处转移率,异质性分析P=0.70,治疗组患者的远处转移率显著低于治疗组患者,差异有统计学意义(P<0.05)。依据WHO抗癌药物不良反应标准,异质性分析均较好,治疗组患者的胃肠道反应、口腔黏膜反应和白细胞减少发生率均显著低于对照组患者,差异有统计学意义(P<0.05)。结论同期放化疗治疗中晚期鼻咽癌的疗效较常规放疗好,能有效提升患者的1年、3年和5年生存率,降低患者的远处转移率、胃肠道反应、口腔黏膜反应和白细胞减少发生率。

Objective To evaluate the efficacy of concurrent chemoradiotherapy in the treatment of intermediate and advanced nasopharyngeal carcinoma（ NPC） by Meta analysis. Methods The literature was searched,the quality of the literature was evaluated,and the data were extracted to analyz statistically the efficacy of concurrent chemoradiotherapy for intermediate and advanced NPC. Results Ten studies provided 1-year survival rate. In the heterogeneity analysis,P = 0. 75. The 1-year survival rate was significantly higher in the treatment group than in the control group（ P〈0. 05）. Fourteen studies provided 3-year survival rate,and in the heterogeneity analysis,P = 0. 99. The 3-year survival rate was significantly higher in the treatment group than in the control group（ P〈0. 05）. Eight studies provided 5-year survival rate,and in the heterogeneity analysis,P = 0. 74. The 5-year survival rate was significantly higher in the treatment group than in the control group（ P〈0. 05）. Seven studies provided distant metastasis rate,and according to the heterogeneity analysis,P = 0. 70. The distant metastasis rate was significantly lower in the treatment group than in the control group（ P〈0. 05）. According to WHO standard on adverse reactions for anticancer agents,all had good heterogeneity,and the incidence of gastrointestinal reactions,oral mucositis,and leucopenia was significantly lower in the treatment group than in the control group（ P〈0. 05）. Conclusion The curative efficacy of concurrent chemotherapy in treatment of advanced nasopharyngeal carcinoma is better than conventional radiotherapy. It can effectively improve the 1-year,3-year and 5-year survival rates,and reduce the incidence of distant metastasis,gastrointestinal reactions,oral mucositis,leucopenia.