IB-Ⅱ期宫颈癌根治术后辅助化疗的meta分析

发布时间：2018-02-21 12:31

  本文关键词： 宫颈癌 宫颈癌根治术 术后化疗 术后辅助治疗 meta分析　出处：《山东大学》2014年硕士论文　论文类型：学位论文

【摘要】：研究目的： 评价宫颈癌根治术后辅助化疗的有效性和安全性。 资料和方法： 联机检索PubMed数据库、EMbase数据库、Cochrane library数据库、中国科技期刊全文数据库、中国(CNKI)学术文献总库、数字化期刊全文数据库(万方)、中国生物医学数文献据库；手工检索山东大学图书馆的相关杂志、学位论文、会议论文等。检索语言种类限制为英文和中文,检索时间不限。试验组行术后辅助化疗,对照组行术后辅助放疗、放化疗或术后观察,对收集的文献进行评价,剔除不合本文研究目的文献。 结果： 共纳入10篇文献,1302例患者入选。应用ReviewManagers5.1进行meta分析。Meta分析显示： 1.术后辅助化疗的有效性： (1)术后辅助化疗组的5年总生存率显著高于术后观察组(RR=1.10,95%CI=[1.00,1.21],P=0.040.05)。 (2)术后辅助化疗组的3年累计无瘤生存率显著高于术后辅助放疗组(RR=1.36,95%CI=[1.09,1.71],P=0.0080.05),5年累计无瘤存率无显著差异(RR=1.03,95%CI=[0.93,1.15],P=0.570.05)；3年和5年总生存率均无显著差异(RR=1.10,95％CI=[0.83,1.45],P=0.500.05；RR=1.07,95％CI=[0.98,1.18],P=0.150.05)；盆腔复发率及远处转移率均无显著差异(RR=1.05,95%CI=[0.52,2.10],P=0.900.05；RR=0.68,95％CI:[0.46,1.01],P=0.060.05)。 (2)术后辅助化疗组与术后辅助放化疗组的5年累计无瘤生存率无显著差异(RR=1.14,95%CI=[0.92,1.42],P=0.220.05)。 2.术后辅助化疗的安全性 (1)术后辅助化疗组的肠道和膀胱功能障碍的发生率均显著低于术后辅助放疗组(RR=0.06,95％CI.[0.02,0.24],P0.00010.05；RR=0.10,95％CI=[0.03,0.29],P=0.00010.05)。 (2)术后辅助化疗组阴道狭窄、无性生活、围绝经期症状的发生率均显著低于术后辅助放疗组,术后辅助化疗组与辅助放疗组出现性交痛的发生率无显著差异。 结论： 对于有复发危险因素的I B-Ⅱ期宫颈癌患者,宫颈癌根治术后辅助化疗与术后观察相比治疗效果更佳,与术后以放疗为基础的辅助治疗的治疗效果相当且相关副反应及并发症的发生率更低,因此术后辅助化疗作为有复发危险因素的IB-Ⅱ期宫颈癌患者根治术后的辅助治疗安全有效。
[Abstract]:Objectives of the study:. To evaluate the efficacy and safety of adjuvant chemotherapy after radical resection of cervical cancer. Information and methods:. On-line retrieval of PubMed database: Cochrane library database, full text database of Chinese scientific and technological journals, general library of academic documents in China, full text database of digital periodicals (Wanfang Pao, Chinese Biomedical Digital document Database); Manual retrieval of related magazines, dissertations, conference papers, etc. The retrieval languages are limited to English and Chinese, and the retrieval time is unlimited. The experimental group received postoperative adjuvant chemotherapy, the control group received postoperative adjuvant radiotherapy, and the control group received postoperative adjuvant radiotherapy. Chemoradiotherapy or postoperative observation were performed to evaluate the collected literature, which did not fit the purpose of this study. Results:. A total of 1302 patients were included in 10 articles. Meta analysis and meta-analysis with ReviewManagers5.1 showed that:. 1. The efficacy of postoperative adjuvant chemotherapy:. 1) the 5-year overall survival rate in the adjuvant chemotherapy group was significantly higher than that in the observation group (CI = [1.00 卤1.21]). (2) the 3-year cumulative tumor-free survival rate in the adjuvant chemotherapy group was significantly higher than that in the postoperative adjuvant radiotherapy group (P = 1.3695CI = [1.0991.71] P0.0080.05C), and there was no significant difference in the 5-year cumulative tumor-free survival rate between the two groups. There was no significant difference in the incidence of pelvic recurrence and distant metastasis. There was no significant difference in the 3-year and 5-year overall survival rates. The overall 3-year and 5-year survival rates were not significantly different between the two groups (P = 0.500.05RR1.0795CI = [0.9881.18] P 0.150.055.There was no significant difference in the pelvic recurrence rate and the distant metastasis rate. There was no significant difference in the overall survival rate for 3 years and 5 years; the total 3-year and 5-year survival rates were not significantly different between the three years and five years. The total survival rates for 3 years and 5 years were higher than that for the radiotherapy group (P = 0.503.695 CI = [0.981.18] P 0.150.055.There was no significant difference in the pelvic recurrence rate and the distant metastasis rate. There was no significant difference in the overall survival rate for 3 years and 5 years. The overall survival rate for 3 and 5 years was not significantly different. (2) there was no significant difference between the postoperative adjuvant chemotherapy group and the postoperative adjuvant chemotherapy group in the 5-year cumulative tumor-free survival rate. 2. Safety of postoperative adjuvant chemotherapy. 1) the incidence of intestinal and bladder dysfunction in the postoperative adjuvant chemotherapy group was significantly lower than that in the postoperative adjuvant radiotherapy group. (2) the incidence of vagina stenosis, non-sexual life and peri-menopausal symptoms in the adjuvant chemotherapy group was significantly lower than that in the postoperative adjuvant radiotherapy group, but there was no significant difference between the adjuvant chemotherapy group and the adjuvant radiotherapy group in the incidence of coitus pain. Conclusion:. For patients with stage IB- 鈪，

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