目的:系统评价新辅助化疗与单纯手术治疗食管癌的疗效与安全性。方法:计算机检索Pub Med、EMBASE、The Cochrane Library、Web of Science、中国生物医学文献数据库、万方数据库、中国期刊全文数据库、中文科技期刊数据库,同时辅以手工检索,收集所有比较新辅助化疗与单纯手术治疗食管癌的随机对照试验(RCTs)。采用Cochrane协作网提供的Rev Man 5.2软件进行统计分析。结果:共纳入13个RCTs,新辅助化疗组(CS组)、单纯手术组(S组)及新辅助放疗组共3295例,Meta分析结果显示两组患者的根治切除率差异有统计学意义,其RR(95%CI)为1.20(1.13,1.27)。3年生存率、5年生存率方面差异有统计学意义,其RR(95%CI)分别为1.16(1.03,1.30)、1.21(1.06,1.39)。无病生存期差异有统计学意义,其RR(95%CI)为1.33(1.22,1.46)。1年生存率、围手术期死亡率差异无统计学意义。结论:与单纯手术相比,新辅助化疗提高了食管癌患者的根治性切除率,可使患者生存获益。
Objective:To evaluate the efficacy and safety of neoadjuvant chemotherapy( CS group)or surgery alone (S group)in the treatment of resectable esophageal neoplasms. Methotls: Medline and manual searches was conducted in PubMed, Cochrane Library, EMbase, CBM Database, CNKI Database, VIP Database and Wanfang Database. The se- lection contents were to identify all published and unpublished RCTs that compared neoadjuvant chemotherapy and surgery with surgery alone for resectable esophageal neoplasms. Meta - analysis was conducted by using RevMan 5.2 software. Results:Thirteen RCTs which included 3295 patients were selected. There were significant diferences be- tween CS group and S group in radical resection rate,3 -year survival rate ,5 -year survival rate, disease free survival ; the RR value and 95 % CI were 1.20 ( 1.13,1.27 ) , 1.16 ( 1.03,1.30 ), 1.21 ( 1.06,1.39 ), 1.33 ( 1.22,1.46 ), respectively. But there were no significant differences between CS group and S group in 1 - year survival rate, perioperative mortality. Conclusion: Compared with surgery alone for esophageal neoplasms, neoadjuvant chemotherap im- proves the radical resection rate, it's benefit to the patients in survival.