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目的系统评价热放化三联疗法治疗非小细胞肺癌的疗效及安全性,为临床实践与更深入研究提供参考。方法计算机检索Cochrane Library、PubMed、EMbase、CBM、CNKI、VIP、WanFang Data,同时辅以其他检索,收集所有比较热放化三联与非三联疗法治疗非小细胞肺癌的随机对照试验(RCT)。各数据库检索时间均从建库至2011年5月1日。参考Cochrane质量评价标准并结合本研究特点对纳入研究进行质量评价后,采用RevMan 5.1软件进行Meta分析。结果共纳入8个RCT,546例患者。Meta分析结果显示:①总有效率:热放化三联疗法的总有效率高于其它非三联疗法,其中三联疗法对比放化、热化及单化的差异有统计学意义,其OR值及其95%CI分别为2.05(1.18,3.56)、3.41(1.12,10.38)和6.11(1.20,31.16)。②在放射性肺炎、放射性食管炎及粒细胞减少的安全性指标方面,热放化三联疗法的发生率均低于放化二联疗法的发生率,但只有粒细胞减少发生率的差异有统计学意义[OR=0.34,95%CI(0.19,0.59)]。结论与其它疗法相比,热放化三联疗法治疗非小细胞肺癌有提高疗效和安全性的趋势,但有待更多试验进一步证实;热放化三联疗法有效性和安全性均优于常规的放化二联疗法,但尚缺乏长期疗效和更全面的安全性的相关证据。
Objective To systematically evaluate the efficacy and safety of thermal-radiation triple therapy in the treatment of non-small cell lung cancer and provide reference for clinical practice and further research. Methods All the randomized controlled trials (RCTs) of non-small cell lung cancer (NSCLC) and triple therapy with thermotherapy were compared with those of non-triple therapy in the Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP and WanFang Data. The database search time from the database to May 1, 2011. Meta-analysis was performed using RevMan 5.1 software after evaluating the quality of the included studies based on the Cochrane quality evaluation criteria and the characteristics of this study. Results A total of 8 RCTs were enrolled, 546 patients. The results of Meta analysis showed that: (1) The total effective rate: The total effective rate of thermal radiotherapy triple therapy was higher than other non-triple therapy, in which the difference of triple radiotherapy, radiotherapy and chemotherapy was statistically significant, the OR value and its The 95% CIs were 2.05 (1.18, 3.56), 3.41 (1.12, 10.38) and 6.11 (1.20, 31.16), respectively. ② in the safety of radiation pneumonitis, radiation esophagitis and neutropenia, the incidence of heat-radiation triple therapy were lower than the incidence of radiotherapy and chemotherapy, but only the incidence of neutropenic differences were statistically Significance [OR = 0.34, 95% CI (0.19, 0.59)]. Conclusions Compared with other therapies, the combination of thermal-radiation triple therapy for non-small cell lung cancer has the trend of improving the efficacy and safety, but more trials are needed to confirm that the efficacy and safety of thermal-radiotherapy triple-therapy are better than those of conventional ones However, there is a lack of evidence of long-term efficacy and more comprehensive safety.