论文部分内容阅读
目的:评价术前放化疗联合手术治疗(neoadjuvant chemoradiotherapy and surgery,CRT+S)与单纯手术治疗(surgery,S)对可切除食管鳞癌患者生存及手术的影响。方法:检索PubMed系统中所有CRT+S与S治疗可切除食管鳞癌的随机对照研究(randomized controlled trial,RCT),应用RevMan 5.2软件进行Meta分析。结果:共纳入10篇文献。CRT+S与S组比较:1)患者1年生存率差异无统计学意义,RR=1.03,95%CI为0.96～1.10,P=0.37。2)CRT+S组提高了3、5年生存率,3年RR=1.32,95%CI为1.17～1.50,P<0.001;5年RR=1.24,95%CI为1.03～1.49,P=0.02。3)相比于S组,CRT+S组的手术率较低,RR=0.84,95%CI为0.72～0.99,P=0.04;术后并发症的发生率较高,RR=1.25,95%CI为1.02～1.53,P=0.03;死亡率也较高,RR=2.34,95%CI为1.37～3.99,P=0.002;但提高了R0切除率,RR=1.18,95%CI为1.06～1.32,P=0.002。4)术后局部复发率差异无统计学意义,RR=0.82,95%CI为0.31～2.16,P=0.68;术后远处转移率差异无统计学意义,RR=0.86,95%CI为0.60～1.22,P=0.39。结论:CRT+S治疗明显提高了可切除食管鳞癌患者的长期生存率及R0切除率。
Objective: To evaluate the effect of preoperative chemoradiotherapy and surgery (CRT + S) and surgery (S) on the survival and operation of resectable esophageal squamous cell carcinoma patients. METHODS: Randomized controlled trial (RCT) of all patients with resected esophageal squamous cell carcinoma (CRT + S and S) in PubMed system was searched. Meta-analysis was performed using RevMan 5.2 software. Results: A total of 10 articles were included. The CRT + S group compared with the S group: 1) There was no significant difference in the 1-year survival rate between patients with CRT and S + group (RR = 1.03, 95% CI 0.96-1.10, P = 0.37.2) RR = 1.32, 95% CI 1.17-1.50, P <0.001; 5 years RR = 1.24, 95% CI 1.03-1.49, P = 0.02.3) Compared with S group, CRT + S group RR = 0.84, 95% CI 0.72-0.99, P = 0.04; The incidence of postoperative complications was high, RR = 1.25, 95% CI 1.02-1.53, P = 0.03; The mortality rate RR = 2.34, 95% CI 1.37- 3.99, P = 0.002; however, R0 resection rate was improved, RR = 1.18, 95% CI was 1.06-1.32, P = 0.002.4) The local recurrence rate There was no significant difference between the two groups (RR = 0.82, 95% CI 0.31-2.16, P = 0.68). There was no significant difference in the distant metastasis rate after surgery between the two groups (RR = 0.86, 95% CI 0.60-1.22, P = 0.39). Conclusion: Long-term survival rate and R0 resection rate of patients with resectable esophageal squamous cell carcinoma were significantly improved by CRT + S treatment.