中晚期非小细胞肺癌支气管动脉灌注化疗的Meta分析

Bronchial arterial infusion chemotherapy for advanced non-small cell lung cancer(Cochrane Review)

背景 支气管动脉灌注介入治疗能否真正给中晚期非小细胞肺癌患者带来益处仍存在争议。目的评价肺癌的介入治疗在临床中晚期非小细胞肺癌的反应率、生活质量、生存期中的意义。检索策略 通过CBM disc、MEDLINE等数据库全面检索国内外已发表和未发表的相关文献。选择标准 支气管动脉灌注化疗与以铂类为基础的全身静脉化疗疗效比较的随机对照试验(RCT)或半随机对照试验(QRCT)。资料收集和分析 由2位评价者按照上述检索策略收集文献,排除不符合选择标准的试验,主要对反应率进行Meta分析。结果 支气管动脉灌注化疗与以铂类为基础的全身静脉化疗相比,治疗非小细胞肺癌的反应率提高11％,但无统计学意义。结论 目前仍不能把支气管动脉灌注介入治疗作为一种与手术、化疗或放疗并行治疗中晚期非小细胞肺癌的基本模式。有必要开展更多设计实施良好的临床随机对照试验以解决这一争议。

Background: The role of bronchial arterial infusion(BAI) in the treatment of patients with advanced non-small cell lung cancer(NSCLC) was not clear. A systematic review and quantitative meta-analysis was therefore undertaken to investigate whether or not patients benefit more or less from BAI. Objectives: To evaluate the effect of BAI on response rate, life quality and survival in patients with advanced NSCLC. Search Strategy: MEDLINE and CMBdisc searches were supplemented by information from trial registers. Selection criteria: RCT or QRCT for BAI and intravenous cisplatin-containing chemotherapy regiments. Data collection and analysis: A quantitative meta-analysis using updated information basing on inclusion and exclusion criteria from all available RCT or QRCT was carried out by two reviewers. The meta-analysis was based on response rate. Results: 11% relative increase was obtained in patients treated by BAI compared with intravenous chemotherapy on response rate. But there is no significant statistical difference. Conclusion: There is not enough evidence to suggest that BAI is as good as surgery, chemotherapy and radiotherapy as a treatment for lung cancer and may justify further research.