新辅助放化疗对中低位直肠癌临床结局的Meta分析

发布时间：2018-01-12 00:34

本文关键词：新辅助放化疗对中低位直肠癌临床结局的Meta分析　出处：《青岛大学》2015年硕士论文　论文类型：学位论文

【摘要】：研究目的:直肠癌是我国常见的恶性肿瘤,随着生活水平的提高及饮食习惯原因的改变,其发病率呈逐渐上升趋势。外科手术切除仍然是直肠癌主要的治疗手段,但中低位直肠癌患者术后局部复发率高,保肛率低,治疗效果不尽人意。近年,直肠癌新辅助治疗逐渐受到广泛关注,本研究使用Meta分析的方法对术前实施新辅助放化疗和未实施治疗的中低位直肠癌的临床疗效和临床结局进行比较。研究方法:通过自由词与主题词结合方式,检索万方、维普、相关期刊论文(CNKI)、Pub Med、Cochrane Library等数据库以公开发表的比较中低位直肠癌新辅助治疗与单纯手术或术后辅助治疗的随机对照试验,对这些文献进行质量评价,对符合标准的文献提取相应数据进行Meta分析。结果:最终11篇随机对照试验,共7407位病人纳入分析,新辅助治疗组3685,对照组3722人。中低位直肠癌新辅助治疗组5年生存率(HR=1.15,95%CI 1.04~1.28,P=0.007)、保肛手术率(HR=1.48,95%CI 1.17~1.87,P=0.001)、局部复发率(OR=0.43,95%CI 1.04~1.28,P0.0001)与对照组比较有显著统计学差异,1年后毒副作用观察组的胃肠道反应III度、骨髓抑制III度发生率分别为8.33%、4.17%,对照组的胃肠道反应III度、骨髓抑制III度发生率分别为33.33%、29.17%。观察组明显低于对照组,两组数据对比有统计学意义(P0.05)。结论:新辅助治疗能提高中低位直肠癌的5年生存率及保肛率、降低局部复发率,不会增加毒副作用。能显著改善其临床结局。
[Abstract]:Objective: rectal cancer is a common malignant tumor in China, with the improvement of living standards and the changes of dietary habits. Surgical resection is still the main treatment for rectal cancer, but the local recurrence rate is high, anal preservation rate is low, and the therapeutic effect is not satisfactory in recent years. Neoadjuvant therapy for rectal cancer has gradually received wide attention. In this study, Meta analysis was used to compare the clinical efficacy and outcome of neoadjuvant chemoradiotherapy and non-treatment in patients with middle and low rectal cancer. Through the combination of free words and theme words. To search the full text database of Wanfang, Weipu and Chinese periodicals, we can find Pub Med. Cochrane Library and other databases compared publicly published randomized controlled trials of neoadjuvant therapy with surgery alone or postoperative adjuvant therapy for middle and low rectal cancer. The quality of these documents was evaluated and the corresponding data were extracted for Meta analysis. Results: in the final 11 randomized controlled trials, a total of 7407 patients were included in the analysis. The 5-year survival rate of neoadjuvant therapy group was 3685 and that of control group was 3722. The 5-year survival rate of neoadjuvant therapy group was 1.1595 CI 1.041.28. The rate of sphincter preserving operation was 1.48 ~ 95% CI 1.17 ~ 1.87 ~ 1.87% P ~ (0.001) and local recurrence rate was 0.43. Compared with the control group, the III degree of gastrointestinal reaction in the observation group was significantly different from that in the control group after 1 year. The incidence of III degree of bone marrow suppression was 8.33 and 4.17 respectively. The incidence of gastrointestinal reaction III degree and III degree of bone marrow suppression were 33.33% in the control group. 29.17. the observation group was significantly lower than the control group, and the data of the two groups were significantly lower than that of the control group (P 0.05). Conclusion: neoadjuvant therapy can improve the 5-year survival rate and anal preservation rate of middle and low rectal cancer. Reducing local recurrence rate without increasing toxic side effects can significantly improve the clinical outcome.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.37

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