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1、重慶醫(yī)學(xué)2014年9月第43卷第26期3445論著·臨床研究doi:10.3969/j.issn.1671—8348.2014.26.014進展期胃癌術(shù)后化療效果的Meta分析謝勇,傅仲學(xué)△(重慶醫(yī)科大學(xué)附屬第一醫(yī)院胃腸外科400016)摘要:目的系統(tǒng)分析進展期胃癌根治術(shù)后輔助化療對患者生存期的影響。方法通過檢索CNKI、PubMed、Elsevier電子期刊、Springer電子期刊、Oxford電子期刊獲取2003年1月至2013年12月來國內(nèi)外公開發(fā)表的相關(guān)文獻,收集以術(shù)后輔助化療與單純手術(shù)比較的前瞻性隨機對照研究共l1篇,使用Cochrane協(xié)作網(wǎng)提供的統(tǒng)計軟件RevMan
2、ager5.2對效應(yīng)量進行合并,對總生存期、無病生存期、無復(fù)發(fā)生存期方面進行定量系統(tǒng)評價。結(jié)果共納入11篇前瞻性隨機對照文獻,Jadad量表評分均4分及以上,共4433例患者,其中手術(shù)加術(shù)后化療為2203例,單純手術(shù)為2230例,結(jié)果分析提示術(shù)后輔助化療使患者生存期明顯獲益,差異有統(tǒng)計學(xué)意義。0S:HR一0.80,95CI(0.73,0.88),P<0.01;DFS:HR一0.78,95CI(0.63,0.97),P一0.02;RFS:HR一0.67,95CI(O.53,0.85),P一0.001。結(jié)論術(shù)后輔助化療能使胃癌根治術(shù)后患者總生存期明顯獲益,D2根治術(shù)后給予口服卡培他濱聯(lián)
3、合奧沙利鉑或口服單藥替吉奧輔助化療可能是目前最佳方案。關(guān)鍵詞:胃腫瘤;化學(xué)療法,輔助;生存期;Meta分析中圖分類號:R735.2文獻標(biāo)識碼:A文章編號:1671—8348(2014)26—3445—04Meta-analysisoneffectofpostoperativeadjuvantchemotherapyforadvancedgastriccancerXieYong,F(xiàn)uZhongxue(DepartmentofGastrointestinalSurgery,F(xiàn)irstAffiliatedHospital,ChongqingMedicalUniversity,Chongq
4、ing400016,China)Abstract:0bjectiveTosystematicallyanalyzetheeffectofadjuvantchemotherapyafterradiealoperationinadvancedgastriccancer.MethodsTherelatedliteraturespublishedathomeandabroadwereretrievedfromtheelectronicdatabasesincludingCNKI,PubMed,Elsevier,Springer,OxfordfromJanuary2003toDecember
5、2013,then11articlesoftherandomizedcontrolledtrial(RCT)ofthecomparisonbetweenthepostoperativeadjuvantchemotherapyandsimpleoperationwerecollected.Theeffectmergingandthequantitativesystematicevaluationintheaspectsofthetotalsurvival,diseasefreesurvivalandrelapsefreesurvivalwereper—formedwithRevMan
6、5.2providedbytheCochranecollaborationnetwork.Results11articlesofRCTwereineludedwith4pointsandmorebytheJadadscale,involving4433patients,amongthem2203patientswithoperationpluspostoperativechemotherapyand2230patientswithsurgeryalone.Theresultsanalysisindicatedthatthepostoperativeadjuvantchemother
7、apymadethepa—tientstoobtaintheapparentbenefitduringsurvivalperiod,thesignificantdifferencehadstatisticalsignificance.OS:HR一0.80,95CI(O.73,0.88),P<0.01;DFS:HR一0.78,95CI(O.63,0.97),P=0.02;RFS:HR一0.67,95CI(0.53,0.85),P一0.001.ConclusionThep