| 吴德俊,丁 玥,王廷峰.新辅助治疗与前期手术在可切除胰腺癌比较的Meta分析[J].肿瘤学杂志,2021,27(2):116-124. |
| 新辅助治疗与前期手术在可切除胰腺癌比较的Meta分析 |
| A Meta-analysis of Neoadjuvant Therapy Versus Upfront Surgery in Resectable Pancreatic Cancer |
| 投稿时间：2020-01-05 |
| DOI：10.11735/j.issn.1671-170X.2021.02.B006 |
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| 中文关键词: 新辅助治疗 可切除 胰腺肿瘤 预后 meta分析 |
| 英文关键词:neoadjuvant therapy resectabl pancreatic cancer prognosis meta-analysis |
| 基金项目:上海市浦东医院学科建设计划项目资助（Zdxk2020-01） |
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| 中文摘要: |
| 摘 要：［目的］ 比较新辅助治疗（neoadjuvant therapy，NAT）和前期手术在可切除胰腺癌（resectable pancreatic cancer，RPC）中的临床差异。［方法］ 计算机检索Pubmed、Embase、Web of Science和Cochrane数据库，纳入未进行新辅助治疗直接进行手术切除（前期手术组）和接受新辅助治疗后进行手术切除（NAT组）的可切除胰腺癌患者。根据异质性选择随机效应模型或固定效应模型计算文献合并的比值比(odds ratio，OR)与危险比（hazard ratio，HR）及其95%可信区间（95% confidence interval，95%Cl）。在没有提供HR的文献中，从文中提供的生存曲线提取HR及其95%CI，同时使用漏斗图与Egger’s检验的方法评估发表偏倚。［结果］ 共纳入11项研究，9386例患者。在所纳入的患者中，有2508例（26.7％）接受了NAT治疗。与前期手术相比，NAT可提高RPC患者的R0切除率（OR=1.89，95％CI：1.26～2.83），同时降低淋巴结阳性率（OR=0.34，95％CI：0.31～0.37）。但接受NAT的RPC患者的总生存（overall survival，OS）时间未显著增加（HR=0.93，95％CI：0.83～1.04）。［结论］ 在RPC患者中，NAT组的R0切除率和淋巴结阳性率均优于前期手术患者。 |
| 英文摘要: |
| Abstract：［Objective］ To compare clinical efficacy between neoadjuvant therapy(NAT) and upfront surgery in resectable pancreatic cancer(RPC). ［Method］ PubMed，EMBASE，Web of Science and the Cochrane Register of Controlled Trials databases were searched. Only patients with RPC who underwent tumor resection and received adjuvant or neoadjuvant treatment were enrolled. The odds ratio(OR) or hazard ratio(HR) and its 95% confidence intervals(CI) were calculated employing fixed-effects or random-effects models according to its heterogeneity. If the HR and its 95%CI were not provided in the article，they were extracted from survival curves. Publication bias was estimated using funnel plots and Egger’s regression test. ［Results］ In total，11 studies were included with 9386 patients. Of these patients，2508(26.7%) received NAT. For patients with RPC，NAT resulted in an increased R0 resection rate(OR=1.89，95%CI：1.26～2.83) and a reduced positive lymph node rate(OR=0.34，95%CI：0.31～0.37) compared with upfront surgery. Nevertheless，patients receiving NAT did not exhibit a significantly increased overall survival(OS) time(HR=0.93，95%CI：0.83～1.04). ［Conclusion］ In patients with RPC，the R0 resection rate and positive lymph node rate of NAT group are superior to those of patients with upfront surgery. |
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