本文關鍵詞：新輔助放化療對中低位直腸癌臨床結局的Meta分析　出處：《青島大學》2015年碩士論文　論文類型：學位論文

  更多相關文章： 中低位直腸癌 新輔助放化療 Meta分析

【摘要】：研究目的:直腸癌是我國常見的惡性腫瘤,隨著生活水平的提高及飲食習慣原因的改變,其發(fā)病率呈逐漸上升趨勢。外科手術切除仍然是直腸癌主要的治療手段,但中低位直腸癌患者術后局部復發(fā)率高,保肛率低,治療效果不盡人意。近年,直腸癌新輔助治療逐漸受到廣泛關注,本研究使用Meta分析的方法對術前實施新輔助放化療和未實施治療的中低位直腸癌的臨床療效和臨床結局進行比較。研究方法:通過自由詞與主題詞結合方式,檢索萬方、維普、相關期刊論文(CNKI)、Pub Med、Cochrane Library等數(shù)據(jù)庫以公開發(fā)表的比較中低位直腸癌新輔助治療與單純手術或術后輔助治療的隨機對照試驗,對這些文獻進行質量評價,對符合標準的文獻提取相應數(shù)據(jù)進行Meta分析。結果:最終11篇隨機對照試驗,共7407位病人納入分析,新輔助治療組3685,對照組3722人。中低位直腸癌新輔助治療組5年生存率(HR=1.15,95%CI 1.04~1.28,P=0.007)、保肛手術率(HR=1.48,95%CI 1.17~1.87,P=0.001)、局部復發(fā)率(OR=0.43,95%CI 1.04~1.28,P0.0001)與對照組比較有顯著統(tǒng)計學差異,1年后毒副作用觀察組的胃腸道反應III度、骨髓抑制III度發(fā)生率分別為8.33%、4.17%,對照組的胃腸道反應III度、骨髓抑制III度發(fā)生率分別為33.33%、29.17%。觀察組明顯低于對照組,兩組數(shù)據(jù)對比有統(tǒng)計學意義(P0.05)。結論:新輔助治療能提高中低位直腸癌的5年生存率及保肛率、降低局部復發(fā)率,不會增加毒副作用。能顯著改善其臨床結局。
[Abstract]:Objective: rectal cancer is a common malignant tumor in China, with the improvement of living standards and the changes of dietary habits. Surgical resection is still the main treatment for rectal cancer, but the local recurrence rate is high, anal preservation rate is low, and the therapeutic effect is not satisfactory in recent years. Neoadjuvant therapy for rectal cancer has gradually received wide attention. In this study, Meta analysis was used to compare the clinical efficacy and outcome of neoadjuvant chemoradiotherapy and non-treatment in patients with middle and low rectal cancer. Through the combination of free words and theme words. To search the full text database of Wanfang, Weipu and Chinese periodicals, we can find Pub Med. Cochrane Library and other databases compared publicly published randomized controlled trials of neoadjuvant therapy with surgery alone or postoperative adjuvant therapy for middle and low rectal cancer. The quality of these documents was evaluated and the corresponding data were extracted for Meta analysis. Results: in the final 11 randomized controlled trials, a total of 7407 patients were included in the analysis. The 5-year survival rate of neoadjuvant therapy group was 3685 and that of control group was 3722. The 5-year survival rate of neoadjuvant therapy group was 1.1595 CI 1.041.28. The rate of sphincter preserving operation was 1.48 ~ 95% CI 1.17 ~ 1.87 ~ 1.87% P ~ (0.001) and local recurrence rate was 0.43. Compared with the control group, the III degree of gastrointestinal reaction in the observation group was significantly different from that in the control group after 1 year. The incidence of III degree of bone marrow suppression was 8.33 and 4.17 respectively. The incidence of gastrointestinal reaction III degree and III degree of bone marrow suppression were 33.33% in the control group. 29.17. the observation group was significantly lower than the control group, and the data of the two groups were significantly lower than that of the control group (P 0.05). Conclusion: neoadjuvant therapy can improve the 5-year survival rate and anal preservation rate of middle and low rectal cancer. Reducing local recurrence rate without increasing toxic side effects can significantly improve the clinical outcome.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R735.37

【參考文獻】

相關期刊論文 前1條

1 羅揚;馮奉儀;;直腸癌的新輔助治療[J];臨床藥物治療雜志;2013年02期

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本文編號：1411952