肝外胆管癌和胆囊癌术后辅助放疗与非放疗疗效的meta分析

中华放射肿瘤学杂志 Pub Date : 2019-11-15 DOI:10.3760/CMA.J.ISSN.1004-4221.2019.11.008

Bixin Ren, Lei Liu, Yongqiang Yang, Q. Guo, Li-yuan Zhang, Ye Tian

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引用次数: 0

摘要

目的通过荟萃分析比较肝外胆管癌和胆囊癌术后辅助放疗和非放疗的疗效。方法从PubMed、EMbase、Cochrane Library、万方数据库、CNKI、重庆VIP和CBM数据库中检索肝外胆管癌和胆囊癌术后辅助放疗与非放疗的对照临床试验。使用RevMan 5.3和Stata 14.0统计软件对获得的数据进行分析。通过计算95%置信区间（CI）的比值比（OR）来估计两组之间的差异。结果本荟萃分析共纳入20项对照临床试验，涉及1258例肝外胆管癌和胆囊癌患者。荟萃分析显示，辅助放疗组的5年生存率显著高于非放疗组（OR=1.67，95%CI:1.29-2.18，P=0.001）。淋巴结阳性疾病（OR=7.44，95%CI:1.24-4.72，P=0.03）和边缘病变阳性（OR=3.43，95%CI:1.56-7.75，P=0.002）的5年存活率显著提高术后辅助放疗。辅助放疗组的局部复发率显著低于非放疗组（OR=0.56，95%CI:0.39-0.80，P=0.01），两组远处转移率差异无统计学意义（OR=1.22，95%CI:0.86～1.73，P=0.027），放疗引起急性毒性和3级以上慢性毒性的发生率分别为0～1.9%和0～217%。结论与非放疗相比，术后辅助放疗是一种更安全、有效的肝外胆管癌和胆囊癌术后治疗方法。关键词：肝外胆管癌/放疗；胆囊癌/放射治疗；辅助治疗；Meta分析

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A meta-analysis of the efficacy of postoperative adjuvant radiotherapy and non-radiotherapy for extrahepatic cholangiocarcinoma and gallbladder carcinoma

Objective To compare the efficacy of postoperative adjuvant radiotherapy and non-radiotherapy in patients with extrahepatic cholangiocarcinoma and gallbladder carcinoma by a meta-analysis. Methods The controlled clinical trials of postoperative adjuvant radiotherapy versus non-radiotherapy of extrahepatic cholangiocarcinoma and gallbladder carcinoma were searched from PubMed, EMbase, Cochrane Library, Wanfang database, CNKI, Chongqing VIP and CBM databases. The obtained data were analyzed using RevMan 5.3 and Stata 14.0 statistical software. The difference between two groups was estimated by calculating the odds ratio (OR) with 95% confidence interval (CI). Results A total of 20 controlled clinical trials involving 1258 extrahepatic cholangiocarcinoma and gallbladder carcinoma patients were included in this meta-analysis. The meta-analysis demonstrated that the 5-year survival rate in the adjuvant radiotherapy group was significantly higher than that in the non-radiotherapy group (OR=1.67, 95%CI: 1.29-2.18, P=0.001). The 5-year survival rates in those with lymph node positive disease (OR=7.44, 95%CI: 1.24-44.72, P=0.03) and positive margins disease (OR=3.43, 95%CI: 1.56-7.75, P=0.002) were significantly enhanced by postoperative adjuvant radiotherapy. The local recurrence rate in the adjuvant radiotherapy group was significantly lower than that in the non-radiotherapy group (OR=0.56, 95%CI: 0.39-0.80, P=0.01), whereas the distant metastasis rate did not significantly differ between two groups (OR=1.22, 95%CI: 0.86-1.73, P=0.27). The incidence rates of acute toxicity and chronic toxicity of grade ≥3 caused by radiotherapy were 0-11.9% and 0-21.7%, respectively. Conclusion Compared with non-radiotherapy, postoperative adjuvant radiotherapy is a safer and more effective postoperative treatment for extrahepatic cholangiocarcinoma and gallbladder carcinoma. Key words: Extrahepatic cholangiocarcinoma/radiotherapy; Gallbladder carcinoma/radiotherapy; Adjuvant therapy; Meta-analysis

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来源期刊

中华放射肿瘤学杂志

自引率

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发文量

6375

期刊介绍： The Chinese Journal of Radiation Oncology is a national academic journal sponsored by the Chinese Medical Association. It was founded in 1992 and the title was written by Chen Minzhang, the former Minister of Health. Its predecessor was the Chinese Journal of Radiation Oncology, which was founded in 1987. The journal is an authoritative journal in the field of radiation oncology in my country. It focuses on clinical tumor radiotherapy, tumor radiation physics, tumor radiation biology, and thermal therapy. Its main readers are middle and senior clinical doctors and scientific researchers. It is now a monthly journal with a large 16-page format and 80 pages of text. For many years, it has adhered to the principle of combining theory with practice and combining improvement with popularization. It now has columns such as monographs, head and neck tumors (monographs), chest tumors (monographs), abdominal tumors (monographs), physics, technology, biology (monographs), reviews, and investigations and research.