【摘要】 目的:评价新辅助化疗联合同步放化疗对比同步放化疗治疗局部晚期鼻咽癌的远期疗效。方法:计算机检索The Cochrane Library(2016年2期)、Pubmed、Embase、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)和万方数据库,对符合纳入标准的研究进行方法学质量评价,采用Rev Man5.3进行Meta分析。结果:共纳入11个研究1 521名患者,结果显示,新辅助化疗联合同步放化疗在5年无远处转移生存率,优于同步放化疗[OR=1.70,95%CI(1.14,2.55),P=0.009],两组的3年生存率,3年无远处转移生存率、3年无进展生存率、3年复发生存率、5年生存率、5年无进展生存率和5年复发生存率无差别(P>0.05)。结论:现有证据表明,与同步放化疗相比,新辅助化疗联合同步放化疗提高了局部晚期鼻咽癌患者的无远处转移生存率,但未提高患者的总生存率。更多还原

【Abstract】 Objective: To evaluate the survival of patients with locally advanced nasopharyngeal carcinoma treated with neoadjuvant chemotherapy followed by concurrent chemoradiotherapy compared with concurrent chemoradiotherapy alone. Methods: Seven databases were searched,including the Cochrane Library(Issue 2,2016),Pubmed,Embase,CBM,CNKI,VIP and Wanfang Database. The methodological quality assessment of eligible researches was conducted according to the Jadad scale and The Newcastal-Ottawa Scale. The Meta-analysis was performed by the Revman 5. 3 software.Results: Eleven researches containing 1 521 patients were finally included. The 5-year distant metastasis-free survival of patients treated with neoadjuvant chemotherapy followed by concurrent chemoradiotherapy was significantly higher than that of those treated with concurrent chemoradiotherapy alone[OR = 1. 70,95% CI(1. 14,2. 55),P = 0. 009]. There were no significant difference in 3-year overall survival,3-year distant metastasis-free survival,3-year progression-free survival,3-year recurrence free survival,5-year overall survival,5-year progression-free survival and 5-year recurrence free survival(P > 0. 05) respectively between these two regimens. Conclusion: Current evidence shows that compared with concurrent chemoradiotherapy alone,neoadjuvant chemotherapy followed by concurrent chemoradiotherapy could improve distant metastasis-free survival in locally advanced nasopharyngeal carcinoma,while no difference was found of the total survival between these two regimens.更多还原