腔内热疗联合放化疗治疗局部晚期宫颈癌安全性和疗效的Meta分析
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四川省南充市科研项目(Ky-15A0026.1)


Meta-analysis of intracavitary hyperthemia combined with radiochemotherapy for advanced cervical carcinoma
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    摘要:

    【摘要】目的 系统评价腔内热疗联合放化疗治疗局部晚期宫颈癌的安全性和疗效。方法采用 Cochrane 系统 Meta分析方法, 检索 Medline、Cochrane 图书馆、CNKI、维普、万方数据库等电子资料库。由 3 名评价者共同评价纳入研究质量, 对纳入研究文献进行 Meta分析。结果 共纳入8个随机对照研究, 618 例局部晚期宫颈癌。Meta 分析显示:腔内热疗联合放化疗组(治疗组)与单纯放化疗组(对照组)比较, 白细胞减低、直肠反应、膀胱反应均较轻, 差异有统计学意义(P<0.05);两组有效率、3年生存率比较差异有统计学意义(P<0.05)。恶心呕吐反应及1年生存率比较, 两组无统计学差异(P>0.05)。结论 腔内热疗联合放化疗可提高局部晚期宫颈癌的临床疗效, 降低癌放化疗的不良反应、延长患者生存期, 安全性好,具有临床应用价值。

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    【Abstract】Objective To evaluate the efficacy and safety of intracavitary hyperthemia combined with radiochemotherapy for Advanced cervical carcinoma. Methods MEDLINE, The Cochrane Library, CNKI, VIP and Wan Fang Data were searched. The quality of included studies was evaluated and meta-analysis was performed for the results of homogeneous studies.Results 8 studies involving 618 case of cervical carcinoma were included. The results of metaanalysis showed that, compared with the radiochemotherapy alone group, the radiochemotherapy combined with thermotherapy group not only had significant decreased in the incidence rate of leucopenia(RR=046, 95%CI(0.28, 0.76), P=0.003)、rectal reaction(RR=0.55, 95%CI(0.358, 0.87)、P=0.01)、bladder reaction(RR=046, 95%CI(0.39, 1.03), P=0.07), but also had significant increased in overall effective rates (OR 311, 95% CI(1.85-5.22), P<0.0001) and 3year survival rates (OR=3.05, 95%CI 1.70 to 668, P=0.005). The incidence of vomit and 1year survival rates were no statistically significant between the two groups. Conclusion Intracavitary hyperthermia combined with concurrent radiochemotherapy is more effective in local tumor control and term efficacy compared with radiochemotherapy, it can reduce the incidence rate of leucopenia without increasing treatment toxicity and longterm survival rate.

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  • 在线发布日期: 2017-12-18
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