标题：洛铂联合5-氟尿嘧啶同步放疗治疗局部晚期食管癌的Meta分析

      作者：董克臣，张萌，梁毅，费新雄    鄂东医疗集团市中心医院头颈食管肿瘤内科，湖北 黄石 435000

      卷次： 2019年30卷9期

      【摘要】 目的 评价洛铂联合5-氟尿嘧啶(LF方案)同步放疗治疗局部晚期食管癌的疗效和安全性。方法 计算机检索CNKI、VIP、WanFang Data、The Cochrane Library、Pubmed及Web of Science等数据库，收集LF方案(实验组)和顺铂联合5-氟尿嘧啶(CF方案，对照组)同步放疗治疗局部晚期食管癌的随机对照试验(RCTs)，检索时间为自1998年1月至2018年1月。由两名研究者独立按照纳入与排除标准进行文献筛选、数据提取及质量评价，并运用Revman 5.3软件进行Meta分析。结果 最终纳入4项中文研究，共计260例患者；Meta分析结果显示，实验组治疗有效率(OR=2.39，95%CI 1.32~4.33)、1年生存率(OR=2.34，95%CI 1.25~4.39)、2年生存率(OR=2.53，95%CI 1.46~4.41)均明显高于对照组，差异均具有统计学意义(P<0.05)；实验组恶心、呕吐发生率低于对照组(OR=0.18，95%CI0.10~0.32)，血小板减少发生率高于对照组(OR=2.85，95% CI 1.12~7.25)，差异均具有统计学意义(P<0.05)；两组间白细胞减少的发生率和放射性食管炎的发生率比较差异均无统计学意义(P>0.05)。结论 与CF方案相比，LF方案同步放疗治疗局部晚期食管癌具有一定的优势，但结论尚需高质量的随机对照试验进一步验证。
      【关键词】 食管癌；洛铂；顺铂；5-氟尿嘧啶；系统评价；随机对照试验
      【中图分类号】 R735.1 【文献标识码】 A 【文章编号】 1003—6350（2019）09—1200—05

Meta-analysis of the treatment of locally advanced esophageal carcinoma by lobaplatin combined with5-fluorouracil concurrent radiotherapy.
DONG Ke-chen, ZHANG Meng, LIANG Yi, FEI Xin-xiong. Department ofHead-Neck and Esophageal Oncology Medicine, Huangshi Central Hospital of Edong Medical Group, Huangshi 435000,Hubei, CHINA
【Abstract】 Objective To evaluate the efficacy and safety of lobaplatin combined with 5-fluorouracil (LF-regi-mens) concurrent radiotherapy in the treatment of locally advanced esophageal carcinoma (LAEC). Methods A seriesof databases were electronically searched, including CNKI, VIP, WanFang Data, Cochrane Library, Pubmed, and Web ofScience, to collect randomized controlled trials (RCTs) of LF-regimens (test group) and cisplatin combined with 5-fluo-rouracil (CF-regimens, control group) concurrent radiotherapy for LAEC. The search time was from January 1998 to Jan-uary 2018. Two researchers independently conducted literature screening, data extraction and quality evaluation accord-ing to inclusion and exclusion criteria. RevMan 5.3 software was used for meta-analysis. Results A total of 4 Chinesestudies involving 260 patients with LAEC were eligible for the final analysis. Meta-analysis showed that treatment effi-ciency [OR=2.39, 95% CI (1.32, 4.33)], 1-year overall survival rate [OR=2.34, 95% CI (1.25, 4.39)], 2-year overall sur-vival rate [OR=2.53, 95% CI (1.46, 4.41)] of the test group were significantly higher than those of the control group (P<0.05). The incidence of nausea and vomiting in the test group was lower than that in the control group [OR=0.18, 95%CI (0.10, 0.32)], and the incidence of thrombocytopenia in the test group was higher than that in the control group [OR=2.85, 95% CI (1.12, 7.28)], both differences were statistically significant (P<0.05). There were no significant differencesin the incidence of leukopenia and radiation-induced esophagitis between the two groups (P>0.05). Conclusion Com-pared with CF regimen, LF-regimen concurrent radiotherapy has a certain advantage in the treatment of LEAC. Howev-er, the conclusion still needs high-quality randomized controlled trials to further verify.
      【Key words】 Esophageal carcinoma; Lobaplatin; Cisplatinum; 5-Fluorouracil; Systematic review; Randomizedcontrolled trial·荟萃分析·doi:10.3969/j.issn.1003-6350.2019.09.035