新辅助化疗与初始肿瘤细胞减灭术治疗晚期卵巢癌疗效的系统评价

发布时间：2018-08-19 15:40

【摘要】：目的系统评价新辅助化疗与初始肿瘤细胞减灭术在晚期卵巢癌患者中的疗效。方法计算机检索Pub Med、EMbase、Cochrane library、Web of Science、CBM、Google Scholar等数据库,检索时限均从建库至2015年7月,两名研究者依据纳入和排除标准独立筛选文献和提取数据,参照Cochrane系统评价手册5.1.0和NOS(Newcastle-Ottawa Scale)评分分别进行质量评价,并行Meta分析。结果最终纳入3篇高质量随机对照试验(RCT)和4篇前瞻性研究,共2476例患者。对RCT研究进行Meta分析结果显示:新辅助化疗与初始肿瘤细胞减灭术相比,总生存期延长(P0.001),肿瘤细胞减灭术满意率增高(P0.001),术后28 d内病死率降低(P=0.002),而无进展生存期(P=0.32),随访6个月(P=0.51)和12个月(P=0.89)的生存质量差异无统计学意义。对前瞻性研究行Meta分析结果显示:新辅助化疗与初始肿瘤细胞减灭术相比,无进展生存期缩短(P0.001),肿瘤细胞减灭术满意率升高(P0.001),而手术时间(P=0.84)和住院时间(P=0.23)差异无统计学意义。结论与初始肿瘤细胞减灭术相比,新辅助化疗可延长晚期卵巢癌患者的总生存期,提高肿瘤细胞减灭术满意率,减少术后病死率。此结论尚需更多多中心、高质量的随机对照试验证实。
[Abstract]:Objective to evaluate the efficacy of neoadjuvant chemotherapy and initial tumor cell reduction in patients with advanced ovarian cancer. Methods the Pub Medbase Cochrane library of Scholar and other databases were searched by computer. The retrieval time was from the establishment of the database to July 2015. According to the inclusion and exclusion criteria, the two researchers independently sifted the literature and extracted the data. According to the Cochrane system evaluation manual 5.1.0 and the NOS (Newcastle-Ottawa Scale) score, the quality evaluation was carried out, and the Meta analysis was carried out. Results 2476 patients were included in 3 high-quality randomized controlled trials (RCT) and 4 prospective studies. The results of Meta analysis of RCT study showed that neoadjuvant chemotherapy was compared with initial tumor cell reduction. The total survival time was prolonged (P0.001), the satisfactory rate of tumor cell reduction was increased (P0.001), the fatality rate was decreased (P0. 002) within 28 days after operation (P0. 002), but the progression-free survival time (P0. 32). There was no significant difference in QOL between 6 months (P0. 51) and 12 months (P0. 89). The results of Meta analysis showed that compared with initial tumor cell reduction, neoadjuvant chemotherapy had shorter progression-free survival (P0. 001), higher satisfaction rate (P0. 001), but no significant difference in operation time (P0. 84) and hospital stay (P0. 23). Conclusion Neoadjuvant chemotherapy can prolong the total survival time of patients with advanced ovarian cancer, increase the satisfaction rate of tumor cell reduction, and reduce the postoperative mortality compared with the initial tumor cell reduction surgery. This conclusion needs to be confirmed by more centers and high-quality randomized controlled trials.
【作者单位】：兰州大学第一临床医学院;兰州大学第二医院骨一科;兰州大学第一医院;
【基金】：国家自然科学基金(81450042)
【分类号】：R737.31

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