發(fā)布時間：2018-02-21 12:31

  本文關(guān)鍵詞： 宮頸癌 宮頸癌根治術(shù) 術(shù)后化療 術(shù)后輔助治療 meta分析　出處：《山東大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的： 評價宮頸癌根治術(shù)后輔助化療的有效性和安全性。 資料和方法： 聯(lián)機檢索PubMed數(shù)據(jù)庫、EMbase數(shù)據(jù)庫、Cochrane library數(shù)據(jù)庫、中國科技期刊全文數(shù)據(jù)庫、中國(CNKI)學(xué)術(shù)文獻總庫、數(shù)字化期刊全文數(shù)據(jù)庫(萬方)、中國生物醫(yī)學(xué)數(shù)文獻據(jù)庫；手工檢索山東大學(xué)圖書館的相關(guān)雜志、學(xué)位論文、會議論文等。檢索語言種類限制為英文和中文,檢索時間不限。試驗組行術(shù)后輔助化療,對照組行術(shù)后輔助放療、放化療或術(shù)后觀察,對收集的文獻進行評價,剔除不合本文研究目的文獻。 結(jié)果： 共納入10篇文獻,1302例患者入選。應(yīng)用ReviewManagers5.1進行meta分析。Meta分析顯示： 1.術(shù)后輔助化療的有效性： (1)術(shù)后輔助化療組的5年總生存率顯著高于術(shù)后觀察組(RR=1.10,95%CI=[1.00,1.21],P=0.040.05)。 (2)術(shù)后輔助化療組的3年累計無瘤生存率顯著高于術(shù)后輔助放療組(RR=1.36,95%CI=[1.09,1.71],P=0.0080.05),5年累計無瘤存率無顯著差異(RR=1.03,95%CI=[0.93,1.15],P=0.570.05)；3年和5年總生存率均無顯著差異(RR=1.10,95％CI=[0.83,1.45],P=0.500.05；RR=1.07,95％CI=[0.98,1.18],P=0.150.05)；盆腔復(fù)發(fā)率及遠處轉(zhuǎn)移率均無顯著差異(RR=1.05,95%CI=[0.52,2.10],P=0.900.05；RR=0.68,95％CI:[0.46,1.01],P=0.060.05)。 (2)術(shù)后輔助化療組與術(shù)后輔助放化療組的5年累計無瘤生存率無顯著差異(RR=1.14,95%CI=[0.92,1.42],P=0.220.05)。 2.術(shù)后輔助化療的安全性 (1)術(shù)后輔助化療組的腸道和膀胱功能障礙的發(fā)生率均顯著低于術(shù)后輔助放療組(RR=0.06,95％CI.[0.02,0.24],P0.00010.05；RR=0.10,95％CI=[0.03,0.29],P=0.00010.05)。 (2)術(shù)后輔助化療組陰道狹窄、無性生活、圍絕經(jīng)期癥狀的發(fā)生率均顯著低于術(shù)后輔助放療組,術(shù)后輔助化療組與輔助放療組出現(xiàn)性交痛的發(fā)生率無顯著差異。 結(jié)論： 對于有復(fù)發(fā)危險因素的I B-Ⅱ期宮頸癌患者,宮頸癌根治術(shù)后輔助化療與術(shù)后觀察相比治療效果更佳,與術(shù)后以放療為基礎(chǔ)的輔助治療的治療效果相當且相關(guān)副反應(yīng)及并發(fā)癥的發(fā)生率更低,因此術(shù)后輔助化療作為有復(fù)發(fā)危險因素的IB-Ⅱ期宮頸癌患者根治術(shù)后的輔助治療安全有效。
[Abstract]:Objectives of the study:. To evaluate the efficacy and safety of adjuvant chemotherapy after radical resection of cervical cancer. Information and methods:. On-line retrieval of PubMed database: Cochrane library database, full text database of Chinese scientific and technological journals, general library of academic documents in China, full text database of digital periodicals (Wanfang Pao, Chinese Biomedical Digital document Database); Manual retrieval of related magazines, dissertations, conference papers, etc. The retrieval languages are limited to English and Chinese, and the retrieval time is unlimited. The experimental group received postoperative adjuvant chemotherapy, the control group received postoperative adjuvant radiotherapy, and the control group received postoperative adjuvant radiotherapy. Chemoradiotherapy or postoperative observation were performed to evaluate the collected literature, which did not fit the purpose of this study. Results:. A total of 1302 patients were included in 10 articles. Meta analysis and meta-analysis with ReviewManagers5.1 showed that:. 1. The efficacy of postoperative adjuvant chemotherapy:. 1) the 5-year overall survival rate in the adjuvant chemotherapy group was significantly higher than that in the observation group (CI = [1.00 鹵1.21]). (2) the 3-year cumulative tumor-free survival rate in the adjuvant chemotherapy group was significantly higher than that in the postoperative adjuvant radiotherapy group (P = 1.3695CI = [1.0991.71] P0.0080.05C), and there was no significant difference in the 5-year cumulative tumor-free survival rate between the two groups. There was no significant difference in the incidence of pelvic recurrence and distant metastasis. There was no significant difference in the 3-year and 5-year overall survival rates. The overall 3-year and 5-year survival rates were not significantly different between the two groups (P = 0.500.05RR1.0795CI = [0.9881.18] P 0.150.055.There was no significant difference in the pelvic recurrence rate and the distant metastasis rate. There was no significant difference in the overall survival rate for 3 years and 5 years; the total 3-year and 5-year survival rates were not significantly different between the three years and five years. The total survival rates for 3 years and 5 years were higher than that for the radiotherapy group (P = 0.503.695 CI = [0.981.18] P 0.150.055.There was no significant difference in the pelvic recurrence rate and the distant metastasis rate. There was no significant difference in the overall survival rate for 3 years and 5 years. The overall survival rate for 3 and 5 years was not significantly different. (2) there was no significant difference between the postoperative adjuvant chemotherapy group and the postoperative adjuvant chemotherapy group in the 5-year cumulative tumor-free survival rate. 2. Safety of postoperative adjuvant chemotherapy. 1) the incidence of intestinal and bladder dysfunction in the postoperative adjuvant chemotherapy group was significantly lower than that in the postoperative adjuvant radiotherapy group. (2) the incidence of vagina stenosis, non-sexual life and peri-menopausal symptoms in the adjuvant chemotherapy group was significantly lower than that in the postoperative adjuvant radiotherapy group, but there was no significant difference between the adjuvant chemotherapy group and the adjuvant radiotherapy group in the incidence of coitus pain. Conclusion:. For patients with stage IB- 鈪，

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