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目的:运用循证医学的方法,分析比较胃癌根治性切除术后辅助放化疗(CRT)和单纯化疗(CT)的疗效。方法:计算机检索Embase、PubMed、Medline、万方、CNKI和中国生物医学数据库,根据纳入和排除标准筛选文献,对入选文献的特征、研究结果的内容进行摘录和评价,并对各研究结果进行异质性检验和数据合并。结果:入选6篇随机对照临床研究(RCT),发表于2010-2012年间,均为英文文献,包括1 171名患者。合并分析结果显示,相对于单纯化疗,术后辅助放化疗患者的总体生存率和无病生存率更高(HR=0.78,95%CI 0.63-0.98;HR=0.76,95%CI0.65-0.90),RCT患者的术后局部复发率也更低(RR=0.56,95%CI 0.41-0.77)。结论:根治性切除术后的胃癌患者化疗联合放疗可以提高总体生存率和无病生存率。因本研究纳入文献较少,结论需更多高质量RCT研究证实。
Objective: To evaluate the efficacy of adjuvant chemoradiotherapy (CRT) and chemotherapy alone (CT) after radical resection of gastric cancer by using evidence-based medicine. Methods: Embase, PubMed, Medline, Wanfang, CNKI and China Biomedicine Database were searched by computer. According to the inclusion and exclusion criteria, the literature was screened, the characteristics of the selected documents and the contents of the research results were extracted and evaluated, and the results of each study Qualitative inspection and data consolidation. RESULTS: Six randomized controlled clinical trials (RCTs) were selected and published in the English literature between 2010 and 2012, including 1,171 patients. The pooled analysis showed that the overall survival and the disease-free survival were significantly higher in postoperative adjuvant chemoradiation compared to chemotherapy alone (HR = 0.78, 95% CI 0.63-0.98; HR = 0.76, 95% CI 0.65-0.90 ), Postoperative local recurrence was also lower in patients with RCT (RR = 0.56, 95% CI 0.41-0.77). Conclusions: Chemotherapy combined with radiotherapy in patients with gastric cancer after radical resection can improve the overall survival and disease-free survival rate. Due to the small number of articles included in this study, more high-quality RCT studies are needed to confirm the conclusion.