阿司匹林对直肠癌术前新辅助治疗疗效的Meta分析

Efficacy of aspirin as an adjuvant agent during neoadjuvant chemoradiotherapy for rectal cancer:a Meta-analysis

目的系统评价阿司匹林作为直肠癌术前新辅助治疗的应用效果。方法检索数据库建库至2018年10月内Pub Med、EMbase、Cochrane图书馆、OVID、中国期刊全文数据库、万方数据库中有关直肠癌新辅助治疗中应用阿司匹林的相关文献,检索语言为中文和英文。使用Review Manager 5.3软件进行Meta分析。结果最终纳入符合标准的试验4项,共638例患者。结果显示,研究组肿瘤完全缓解率、肿瘤降期率、肿瘤部分缓解率较对照组高,肿瘤局部复发率较对照组低,差异均有统计学意义(P<0.05),研究组生存率较对照组高。结论阿司匹林可提高直肠癌术前新辅助治疗患者肿瘤完全缓解率、肿瘤部分缓解率、肿瘤降期率、3年生存率、5年生存率和降低患者肿瘤局部复发率,有望成为直肠癌新辅助治疗中的新的有效辅助药物。

Objective To systematically evaluate the efficacy of aspirin as a adjuvant agent during neoadjuvant chemoradiotherapy for rectal cancer.Methods Databases,including PubMed,EMbase,OVID,the Cochrane Library,CNKI and Wanfangdata,were searched from inception to Oct 2018 to obtain relevant literatures about aspirin-use in neoadjuvant chemoradiotherapy for rectal cancer.Use RevMan 5.3 software for Meta-analysis.Results Four trials that fit the criteria were included,involving 638 patients.In the study group,the complete remission rate,the partial remission rate and the tumor down staging rate were higher than those in the control group,with statistically significant difference(P<0.05).The local recurrence rate in the study group was lower than that in the control group,with statistically significant difference.The survival rate in the study group were higher than those in the control group.Conclusion Aspirin can improve complete remission rate,partial remission rate,tumor down staging rate,3-year survival rate,5-year survival rate and reduce local tumor recurrence rate in patients with rectal cancer receiving neoadjuvant chemoradiotherapy and it is expected to become a new adjuvant drug in neoadjuvant chemoradiotherapy of rectal cancer.