您的位置：山东大学 -> 科技期刊社 -> 《山东大学学报（医学版）》

山东大学学报（医学版） ›› 2017, Vol. 55 ›› Issue (10): 76-83.doi: 10.6040/j.issn.1671-7554.0.2017.039

• 临床医学 • 上一篇    下一篇

亚肺叶切除联合125I粒子植入治疗早期肺癌有效性的Meta分析与系统评价

王丽丽,霍彬,王磊,汪浩,侯定坤,霍小东,王金焕,臧立,曹强,柴树德,王海涛   

  1. 天津医科大学第二医院肿瘤科, 天津 300211
  • 收稿日期:2017-01-11 出版日期:2017-10-10 发布日期:2017-10-10
  • 通讯作者: 王海涛. E-mail:peterrock2000@126.com柴树德. E-mail:chaishude@126.com E-mail:peterrock2000@126.com
  • 基金资助:
    国家自然科学基金(81572543);国家肿瘤临床医学研究中心个体化医学平台建设项目(13ZCZCSY20300)

Meta-analysis and system evaluation of 125I implantation in the treatment of early lung cancer

WANG Lili, HUO Bin, WANG Lei, WANG Hao, HOU Dingkun, HUO Xiaodong, WANG Jinhuan, ZANG Li, CAO Qiang, CHAI Shude, WANG Haitao   

  1. Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China
  • Received:2017-01-11 Online:2017-10-10 Published:2017-10-10

PDF (PC)

88

摘要： 目的 评价亚肺叶切除(SR)联合125I粒子植入(SRB)治疗不宜行根治性肺叶切除的早期非小细胞肺癌(NSCLC)患者的有效性。 方法 电子检索PubMed、Embase、Cochrane Library、中国知网、万方数据库、中国生物医学文献数据库,文献检索起止时间均从建库至2016年11月,同时检索纳入文献的参考文献,纳入探讨SR与SRB治疗早期肺癌有效性的临床研究,并逐个进行质量评价,归类分析及资料提取。 结果 共纳入16个研究(n=1 354例)。4个研究(n=612例)比较了SRB对比单独SR治疗早期肺癌的疗效,Meta分析结果显示,SRB虽然有提高SR术后患者局部控制率的趋势,但二者之间差异无统计学意义(P=0.06)。12个单臂研究(n=742)描述了SRB治疗早期肺癌的疾病控制情况,结果显示,患者局部控制率高达96.1%,区域复发或远处转移率为19.1%,1、2、5年的平均生存率分别是84.9%、74.0%、32.1%。 结论 综合现有资料,SRB是治疗早期NSCLC的有效策略,有降低患者局部复发率的趋势。但目前所纳入研究的证据级别较低,有待进一步开展高质量的临床研究。

关键词: 125I粒子植入, 早期非小细胞肺癌, 亚肺叶切除, 有效性, 系统评价, Meta分析

Abstract: Objective To evaluate the efficacy of sublobar resection(SR)and sublobar resection combined with 125I brachytherapy(SRB)in the treatment of early non-small cell lung cancer(NSCLC). Methods The relevant literatures on SR and SRB in the treatment of NSCLC were searched in PubMed, Embase, Cochrane Library, CNKI, Wanfang database, and Chinese CBM database from the inception date to Nov. 2016. The bibliographies of retrieved articles were also enrolled. The studies enrolled were classified, the quality was evaluated, and data were extracted. Results A total of 16 studies(n=1 354)were included, 4 of which compared the efficacy of SR and SRB in the treatment of NSCLC, and 12(n=742)recorded SRB in the treatment of NSCLC. Meta-analysis showed that there was no statistical difference although SRB could reduce local recurrence(P=0.06). For SRB, the local control rate was 96.1%; the probability of local recurrence / distant metastases was 19.1%; the mean survival rate of 1-year, 2-year and 5-year was 84.9%, 74.9% and 32.1%, respectively. Conclusion The evidence shows that SRB is effective in the treatment of NSCLC, which can reduce the local recurrence rate. However, more high-quality studies are needed to confirm the efficacy.

Key words: 125I implantation, Early non-small cell lung cancer, Efficacy, System evaluation, Sublobar resection, Meta-analysis

中图分类号: 

  • R734.2
[1] Jemal A, Bray F, Center MM, et al. Global cancer statistics[J]. CA Cancer J Clin, 2011, 61(2): 69-90.
[2] 赫捷, 赵平, 陈万青. 2012中国肿瘤登记年报[M]. 北京: 军事医学科学出版社, 2012: 13-16.
[3] Sco WJ, Howington J, Feigenberg S, et al. Treatment of non-small cell lung cancer stage I and stage II. ACCP evidencebased clinical practice guidelines[J]. Chest, 2007, 132(Suppl 3): 234-242.
[4] Beckles MA, Spiro SG, Colice GL, et al. The physiologic evaluation of patients with lung cancer being considered for resectional surgery[J]. Chest, 2003, 123(1 Suppl): 105S-114S.
[5] Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer[J]. Ann Thorac Surg, 1995, 60(3): 615-623.
[6] 李玉亮, 王永正, 张福君. CT引导下经皮穿刺植入125I粒子治疗老年中心型肺癌近期疗效分析[J]. 中华肿瘤防治杂志, 2007, 14(23): 1818-1820. LI Yuliang, WANG Yongzheng, ZHANG Fujun. Effect of curing central bronchogenic cancer by percutaneous interstitial 125I particle implanting under CT guided in old patients[J]. Chinese Journal of Cancer Prevention and Treatment, 2007, 14(23): 1818-1820.
[7] 焦德超, 张福君, 陆郦工, 等. 125I粒子组织间植入治疗肺恶性肿瘤[J]. 介入放射学杂志, 2008, 17(3): 190-193. JIAO Dechao, ZHANG Fujun, LU Ligong, et al. CT guided radioactive 125I seed implantation in treating lung malignant tumors[J]. Journal of Interventional Radiology, 2008, 17(3): 190-193.
[8] Madsen JS, Wallstedt B, Brandt CJ, et al. Questions as evident key to knowledge: teaching medical students evidence-based medicine[J]. Ugeskr Laeger, 2001, 163(26):3609-3613.
[9] Santos R, Colonias A, Parda D, et al. Comparison between sublobar resection and 125 iodine brachytherapy after sublobar resection in high-risk patients with stage I non-small-cell lung cancer[J]. Surgery, 2003, 134(4): 691-697.
[10] Fernando HC, Landreneau RJ, Mandrekar SJ, et al. Impact of brachytherapy on local recurrence rates after sublobar resection: results from ACOSOG Z4032(Alliance), a phase Ⅲ randomized trial for high-risk operable non-small-cell lung cancer[J]. J Clin Oncol, 2014, 32(23): 2456-2462.
[11] 曾庆武, 刘俊. 肺楔形切除联合125I粒子植入治疗高危Ⅰ期非小细胞肺癌的临床研究[J]. 中国医药指南, 2010, 8(20): 99-101. ZENG Qingwu, LIU Jun. Clinical study of pulmonary wedge resection combined with 125I seed implantation in the treatment of stage Ⅰ non-small cell lung cancer with high risk[J]. Guide of China Medicine, 2010, 8(20): 99-101.
[12] Fernando HC, Santos RS, Benfield JR, et al. Lobar and sublobar resection with and without brachytherapy for small stage IA non-small cell lung cancer[J]. J Thorac Cardiovasc Surgery, 2005, 129(2): 261-267.
[13] Kotinsley KA, Betler J, Kotinsley B, et al. Outcome analysis of sublobar resection and intraoperative 125I brachytherapy vs. stereotactic body radiotherapy in stage I non-small cell lung carcinoma[J]. Int J Rad Oncol Biol Phys, 2011, 81(2): S162-S163.
[14] Hilaris BS, Nori D, Martini N. Intraoperative radiotherapy in stage Ⅰ and Ⅱ lung cancer[C]. Semin Surg Oncol, 1987, 3(1): 22-32.
[15] Bigdeli G, Adurty R, Kaplan P, et al. Radiographic changes after wedge resection and intraoperative 125I brachytherapy in stage Ⅰ lung cancer[J]. Chest, 2009, 136(4): 140S-c-141S.
[16] Manning MA, Mohamed M, Burney DP. Sublobar resection with 125I brachytherapy for early-stage non-small cell lung cancer(NSCLC)using prefabricated mesh[C]. J Clinic Oncol, 2009, 27(15S): 7586.
[17] Lee W, Daly BDT, DiPetrillo TA, et al. Limited resection for non-small cell lung cancer: observed local control with implantation of 125I brachytherapy seeds[J]. AnnThorac Surg, 2003, 75(1): 237-242.
[18] Voynov G, Heron DE, Lin CJ, et al. Intraoperative 125I Vicryl mesh brachytherapy after sublobar resection for high-risk stage Ⅰ nonsmall cell lung cancer[J]. Brachytherapy, 2005, 4(4): 278-285.
[19] Manning M, Burney D, Bryant C. Efficacy of sublobar resection with 125I brachymesh at two years for early stage non-small cell lung cancer(NSCLC)[J]. Brachytherapy, 2011, 10: S74-S75.
[20] Khuntia D, Weigel TL, Orcutt KP, et al. Intraoperative 125I mesh brachytherapy after wedge resection for medically high risk stage Ⅰ non-small cell lung cancer: the university of wisconsin experience[J]. Brachytherapy, 2010, 9: S84-S85.
[21] Isaac M, Kaminsky A, Onufrey VG, et al. Intraoperative 125I brachytherapy mesh after sublobar resection in early stage high risk non small cell lung cancer[J]. Brachytherapy, 2011, 10: S23-S24.
[22] Evans AJ, Connery C, Bhora F, et al. Sublobar resection and robotic interstitial brachytherapy for early-stage non-small cell lung cancer[J]. Int J Radiat Oncol Biol Phys, 2012, 84(3): S558.
[23] Colonias A, Betler J, Trombetta M, et al. Mature follow-up for high-risk stage Ⅰ non–small-cell lung carcinoma treated with sublobar resection and intraoperative Iodine-125 brachytherapy[J]. Int J Radiat Oncol Biol Phys, 2011, 79(1): 105-109.
[24] Chen A, Galloway M, Landreneau R, et al. Intraoperative 125I brachytherapy for high-risk stage I non-small cell lung carcinoma[J]. Int J Radiat Oncol Biol Phys, 1999, 44(5): 1057-1063.
[25] Okada M, Koike T, Higashiyama M, et al. Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study[J]. J Thorac Cardiovasc Surg, 2006, 132(4): 769-775.
[26] Khullar OV, Liu Y, Gillespie T, et al. Survival after sublobar resection versus lobectomy for clinical stage IA lung cancer: an analysis from the national cancer data base[J]. J Thorac Oncol, 2015, 10(11): 1625-1633.
[27] Speicher PJ, Gu L, Gulack BC, et al. Sublobar resection for clinical stage IA non-small-cell lung cancer in the United States[J]. Clin Lung Cancer, 2016, 17(1): 47-55.
[28] Taioli E, Yip R, Olkin I, et al. Survival after sublobar resection for earlystage lung cancer: methodological obstacles in comparing the efficacy to lobectomy[J]. J Thorac Oncol, 2016, 11(3): 400-406.
[29] Birdas TJ, Koehler RPM, Colonias A, et al. Sublobar resection with brachytherapy versus lobectomy for stage Ib nonsmall cell lung cancer[J]. The Annals of thoracic surgery, 2006, 81(2): 434-439.
[30] 柯明耀, 雍雅智, 罗炳清, 等. 经皮植入125I放射性粒子治疗老年Ⅰ期周围型非小细胞肺癌探讨[J]. 中华放射肿瘤学杂志, 2011, 20(5): 394-396. KE Mingyao, YONG Yazhi, LUO Bingqing, et al. Study of percutaneous 125I seeds implantation guided by CT in elderly patients of stage Ⅰ peripheral non-small cell lung cancer[J]. Chinese Journal of Radiation Oncology, 2011, 20(5): 394-396.
[31] 杨景魁, 吕金爽, 阎卫亮, 等. 放射性粒子植入治疗不能手术的早期非小细胞肺癌疗效分析[J]. 中国肿瘤临床, 2014, 41(17): 1111-1114. YANG Jingkui, LÜ Jinshuang, YAN Weiliang, et al. Analysis of curative effect of implantation of radioactive seeds on inoperable early-stage non-small cell lung cancer[J]. Chinese Journal of Clinical Oncology, 2014, 41(17): 1111-1114.
[32] 杨景魁, 霍小东, 闫卫亮, 等. CT引导下经皮穿刺125I粒子植入治疗非手术的早期非小细胞肺癌疗效分析[J]. 中华老年医学杂志, 2014, 33(7): 757-759. YANG Jingkui, HUO Xiaodong, YAN Weiliang, et al. Effect of CT-guided 125I seeds implant brachytherapy on early non-small cell lung cancer[J]. Chinese Journal of Geriatrics, 2014, 33(7): 757-759.
[1] 林萍珍,薛娇美,杨蓓,李萌,周麦琳,曹枫林. 基于Pearson相关系数的癌症患者创伤后成长与心理适应相关性的Meta分析[J]. 山东大学学报（医学版）, 2017, 55(9): 110-121.
[2] 杜金阁,陈慧,杨孝荣,吕明. STAT4 rs7574865位点单核苷酸多态性与系统性红斑狼疮易感性Meta分析[J]. 山东大学学报（医学版）, 2017, 55(5): 95-102.
[3] 徐闯,戚大春,李贤让,祖萌,李健,刘明廷. 初次髋关节置换术后引流与否的Meta分析[J]. 山东大学学报（医学版）, 2016, 54(6): 43-49.
[4] 木哈达斯·吐尔逊依明,帕它木·莫合买提,托兰古丽·买买提库尔班. CDKAL1(rs10946398 C/A)基因多态性与2型糖尿病易感性关系Meta分析[J]. 山东大学学报（医学版）, 2016, 54(2): 75-85.
[5] 孙祥耀,海涌,张希诺. 经皮内固定术与传统后路开放内固定术治疗胸腰椎骨折不良事件比较的Meta分析[J]. 山东大学学报（医学版）, 2016, 54(11): 56-63.
[6] 苏静, 薛娇美, 孙菲菲, 郭兆新, 程翔宇, 孟力维, 刘照旭. 肾单位保留术和肾癌根治术治疗T1b期肾癌的Meta分析[J]. 山东大学学报（医学版）, 2015, 53(9): 65-70.
[7] 刘京生, 刘桂华, 杜昆, 赵倩, 翁韶波, 赵学英, 张喜庄, 金讯波. 中国人群中血清TK1对不同恶性肿瘤诊断价值的Meta分析[J]. 山东大学学报（医学版）, 2015, 53(9): 71-79.
[8] 吴珍, 宋国栋, 王伟. 他汀类药物对稳定期慢性阻塞性肺病治疗效果的Meta分析[J]. 山东大学学报（医学版）, 2015, 53(2): 12-18.
[9] 王音, 马喆, 陶国伟, 刘韶平, 丁婷婷, 石琳琳. 关于产前诊断胼胝体发育不全患儿预后的Meta分析[J]. 山东大学学报（医学版）, 2015, 53(10): 66-72.
[10] 孙媛媛, 高伟, 崔英, 张红, 焦建芬, 李衎, 徐瑞彩. 肿瘤化疗患者应用植入式静脉输液港与PICC效果比较的系统评价[J]. 山东大学学报（医学版）, 2015, 53(10): 73-81.
[11] 许月芳, 刘皈阳, 张鑫. 氨曲南治疗下呼吸道感染疗效及 安全性的Meta分析[J]. 山东大学学报（医学版）, 2014, 52(Z2): 198-200.
[12] 王威严, 杨清锐, 袁苑, 杨杏林, 张源潮. 类风湿关节炎与TNFAIP3基因多态性关联研究的meta分析[J]. 山东大学学报（医学版）, 2014, 52(8): 75-80.
[13] 赵龙, 关广聚. 十字花科蔬菜摄入量与肾细胞癌罹患风险的Meta分析[J]. 山东大学学报（医学版）, 2014, 52(7): 82-89.
[14] 徐慧荣, 李健宁, 李增军, 徐忠法. 机器人手术与腹腔镜手术在直肠癌低位前切除术中疗效的Meta分析[J]. 山东大学学报（医学版）, 2014, 52(7): 60-65.
[15] 郑加田，朱凯，孙红胜，付敏，潘正论. IL-18和MCP-1基因多态性与类风湿关节炎易感性关系的Meta分析[J]. 山东大学学报（医学版）, 2014, 52(6): 98-104.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
版权所有 © 2018 《山东大学学报(医学版)》编辑部　
地址:山东大学科技期刊社（济南市历城区山大南路27号山东大学中心校区明德楼B座721室） 电话: 0531-88366918 E-mail: xbyxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发