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

doi:10.6040/j.issn.1671-7554.0.2017.039

摘要/Abstract

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

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. 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[J]. 山东大学学报（医学版）, 2017, 55(10): 76-83.

WANG Lili, HUO Bin, WANG Lei, WANG Hao, HOU Dingkun, HUO Xiaodong, WANG Jinhuan, ZANG Li, CAO Qiang, CHAI Shude, WANG Haitao. Meta-analysis and system evaluation of ¹²⁵I implantation in the treatment of early lung cancer[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(10): 76-83.

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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

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

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