【摘要】：目的不可手術局部晚期非小細胞肺癌經誘導化療后同期放化療的獲益情況尚缺乏證據。本研究通過對比不可切除局部晚期非小細胞肺癌經誘導化療后同期放化療與同期放化療2種治療模式下的療效及安全性,望尋求對局部晚期非小細胞肺癌更有效的治療方法,為臨床治療手段提供理論依據。方法計算機檢索The Cochrane Library、PubMed、Embase、Web of Science、CBM和CNKI,同時輔佐其他檢索途徑,搜集2016-06前所有關于局部晚期非小細胞肺癌誘導化療后同期放化療與同期放化療治模式的隨機對照試驗(randomized controlled clinical study,RCT)。質量評價參考2008年Cochrane質量評價標準,統(tǒng)計學分析應用Review Manager 5.2軟件。結果共納入11個RCT。誘導化療后同期放化療與同期放化療治模式總有效率差異無統(tǒng)計學意義,OR=1.30,95%CI為0.96~1.77,P=0.10;1(OR=1.51,95%CI為0.97~2.43,P=0.07)和2(OR=1.34,95%CI:1.00~1.79,P=0.05)年生存率差異無統(tǒng)計學意義,3年生存率差異有統(tǒng)計學意義,OR=1.43,95%CI:1.02~2.01,P=0.04;Ⅲ~Ⅳ級不良反應中,放射性食管炎(OR=1.96,95%CI:1.06~3.62,P=0.03)和白細胞降低(OR=1.84,95%CI:1.24~2.74,P=0.002)差異有統(tǒng)計學意義,放射性肺炎(OR=1.31,95%CI:0.62~2.77,P=0.48)和惡心嘔吐(OR=1.46,95%CI:0.82~2.59,P=0.19)差異無統(tǒng)計學意義。結論誘導化療后同期放化療組Ⅲ~Ⅳ級放射性食管炎、放射性肺炎及白細胞降低發(fā)生率較同期放化療組增多,但無毒性相關死亡,而誘導化療組3年生存率較同期放化療組提高,可考慮為臨床應用。
[Abstract]:Objective there is no evidence of the benefit of radiotherapy and chemotherapy after induction chemotherapy for non-operative advanced non-small cell lung cancer. In this study, the efficacy and safety of non-resectable local advanced non-small cell lung cancer (NSCLC) after induction chemotherapy and simultaneous radiotherapy and chemotherapy were compared, in order to find a more effective treatment for local advanced NSCLC. To provide theoretical basis for clinical treatment. Methods The Cochrane Library,PubMed,Embase,Web of Science,CBM and CNKI, were searched simultaneously with other search methods, and all the randomized controlled trials (randomized controlled clinical study,RCT) were collected before June 2016-06 about concurrent radiotherapy and chemotherapy after induction chemotherapy and concurrent radiotherapy and chemotherapy for local advanced non-small cell lung cancer (NSCLC). According to the quality evaluation standard of Cochrane in 2008, the software Review Manager 5.2 was used in statistical analysis. Results A total of 11 RCT. were included There was no significant difference in the total effective rate between the concurrent radiotherapy and chemotherapy after induction chemotherapy and the concurrent radiotherapy and chemotherapy. There was no significant difference in the total effective rate between the two models. The CI was 0.96 ~ 1.77% (OR=1.51,95%CI = 0.97 ~ 2.43) and 2 (OR=1.34,95%CI:1.00~1.79,P=0.05). There was no significant difference in the 3-year survival rate. There were significant differences in the 3-year survival rate between the OR1.439 95CI1.02P0.01P0.04 and the 鈪，

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