摘要
目的：比较体部立体定向放疗（stereotactic body radiotherapy，SBRT or stereotactic ablative radiothera-py，SABR）与手术治疗早期非小细胞肺癌（non-small cell lung cancer，NSCLC）的疗效。方法通过计算机检索Cochrane图书馆、PubMed、Medline、中国期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）、万方数据库，收集国内外公开发表关于 SBRT与手术治疗早期 NSCLC的相关文献，采取双人平行评价的方法对收集的文献进行评价，提取资料并交叉核对，应用统计软件RevMan5．2进行Meta分析。结果筛查后共纳入4项回顾性研究，均为英文文献，共1265个患者，其中手术治疗914例（手术组），SBRT351例（SBRT组），根据研究内容将两组生存率分为 A、B、C 3组进行 Meta分析，4项研究综合评价2种治疗方法生存率作为 A组，2项研究两组病例进行了1∶1配对，两组在年龄、合并症评分及肿瘤分期等因素方面差异无统计学意义，为 B组；另外2项研究对两组病例也进行了1∶1配对，但两组在年龄、合并症及肺功能等因素方面差异有统计学意义，且手术组优于 SBRT组，为 C组。A组：1、2、3年总生存率差异均有统计学意义（P ＜0．0001～0．00001），手术组优于 SBRT组；B组：1、2年总生存率差异无统计学意义（P ＝0．35；P ＝0．29），3年总生存率差异有统计学意义（P ＝0．02），手术组优于 SBRT组；C组：1、2、3年总生存率差异均有统计学意义（P ＜0．01～0．00001），手术组优于 SBRT组。2项研究中两组肿瘤特异性生存率差异无统计学意义（P ＝0．46，P ＝0．19）。结论由于两组间存在年龄、肺功能及合并症等方面的差异，不能明确得出手术组优于 SBRT组的结论，但两组间肿瘤特异性生存率无差异，两组疗效的比较还需要临床随机对照试验来进一步研究。
Objective This research aimed to compare the efficacy of SBRT and surgical treatment of early-stage NSCLC.Methods By searching the Cochrane Library,PubMed,Medline,Chinese Journal Full-text Database （CNKI）,Chinese Biomedical Literature Database （CBM）and Wan Fang DATA,the published literature about SBRT and surgical treatment of early-stage NSCLC at home and abroad were reviewed for extraction and evaluation by double parallel method and cross checking,and the meta-analyses were con-ducted by RevMan 5 .2 software.Results 4 retrospective English studies involving 1 2 6 5 cases were includ-ed,with 914 surgical treatment cases and 351cases SBRT.Group A,B,C were divided in surgery group and SBRT group：Group A with 4 studies on comprehensive evaluation on the survival rate;Group B with two studies matched by 1∶1 in surgery group and SBRT group,with no statistical significance in age,co-morbidity score and tumor staging;Group C with the other two studies matched by 1∶1 in surgery group and SBRT group,with statistical significance in age,comorbidity score and pulmonary function.Group A：1-year,2-year and 3-year overall survival differences had statistical significance （P〈0.000 1;P〈0.000 01;P 〈0.000 01）,with higher survival rate in surgery group than in SBRT group;Group B：1-year,2-year overall survival differences were not statistically significant （P=0.35;P=0.29）,but 3-year overall surviv-al difference was statistically significant （P =0.02）,with higher survival rate in surgery group than in SBRT group;Group C：1-year,2-year and 3-year overall survival differences had statistical significance （P=0.002;P 〈0.000 01;P 〈0.000 01）,with higher survival rate in surgery group than in SBRT group;There was no statistically significant difference in tumor-specific survival rate in two groups （P=0.46,P=0.19）.Conclusion Due to the differences in age,pulmonary function and complications between two groups,the better results of Surgery group over SBRT group were not definitely decided in the overall sur-vival,but with no difference in the tumor-specific survival rate between the two groups.Therefore,the curative effect of two groups in randomized controlled trials needs to be further explored.
出处
《新疆医科大学学报》
CAS
2014年第5期524-530,共7页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区科技支疆项目(201291171)
河南省国际合作项目(124300510016)
卫生部省部共建项目(201201009)
