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背景与目的术前化疗对于可切除的非小细胞肺癌的作用目前仍不明确,通过荟萃分析对评估术前化疗对于非小细胞肺癌生存率改善的有效性。方法在MEDLINE、PUBMED、OVID、Cochrane图书馆、Cancerlit、ClinicalTrials.gov和ASCO网站、ESMO网站及CBMdisc数据库对相关文献进行了检索并选出符合要求的文献进行meta分析,主要比较了术前化疗后再手术和单独手术对非小细胞肺癌的患者生存率的影响。用死亡风险优势比OR值来评估生存率改善的有效性。结果13个合格的临床随机对照试验入选,共包括了2561个患者。结果表明术前化疗可改善患者的生存率,合并OR值为0.80,95%可信区间0.68-0.94,P=0.008,差异具有统计学意义。亚组分析中显示IIIa期的非小细胞肺癌患者也受益于术前化疗。文献没有统计学异质性。结论此次分析表明术前化疗对于改善非小细胞肺癌患者的生存率有明显益处,Meta分析也是目前评估这种治疗有效性的最好方法。
BACKGROUND & OBJECTIVE: The effect of preoperative chemotherapy on resectable non-small cell lung cancer is still unclear. The efficacy of preoperative chemotherapy in assessing the improvement of survival for non-small cell lung cancer is assessed by meta-analysis. Methods Meta-analysis was performed on MEDLINE, PUBMED, OVID, the Cochrane Library, Cancerlit, ClinicalTrials.gov and ASCO websites, ESMO website and CBMdisc database, and the meta-analysis of selected literature was made. Effect of Reoperation and Individual Surgery on Survival in Patients with Non-small Cell Lung Cancer. The risk-benefit odds ratio (OR) was used to assess the survival benefit improvement. Results Thirteen eligible RCTs were enrolled and included 2,561 patients. The results showed that preoperative chemotherapy can improve the survival rate of patients with OR 0.80,95% confidence interval 0.68-0.94, P = 0.008, the difference was statistically significant. Subgroup analyzes showed that patients with stage IIIa non-small cell lung cancer also benefit from preoperative chemotherapy. The literature has no statistical heterogeneity. Conclusions This analysis shows that preoperative chemotherapy has significant benefits for improving survival in patients with non-small cell lung cancer. Meta-analysis is currently the best way to evaluate the efficacy of this treatment.