CAJ | 학술논문

目的：系统评价热疗联合化疗（热化）与单纯化疗（单化）比较治疗晚期胃癌的疗效和安全性。方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库和万方数据-数字化期刊全文数据库，同时辅以其他检索。收集所有比较热疗联合化疗与单纯化疗的随机对照试验。根据Cochrane系统评价员手册5.1质量评价标准对纳入文献进行质量评价，并使用STATA SE 12.0软件进行Meta分析。结果最终纳入5个随机对照试验（351例晚期胃癌患者）。Meta分析结果显示：在疗效方面，热化组的完全缓解率[OR＝2.13，95％CI（1.17，3.86），P＝0.013]及总有效率[OR＝1.37，95％CI（1.09，1.73），P＝0.006]均高于单化组，其差异均有统计学意义；在安全性方面，热化组与单化组的不良反应均无统计学差异。结论与单纯化疗相比，热疗联合化疗治疗晚期胃癌可明显提高完全缓解率与总有效率，不良反应发生率未增加。受纳入研究质量和数量所限，上述结论尚需开展更多高质量研究，特别是大样本、关注更多主要结局指标的随机对照试验。推荐结合患者具体情况进行临床应用。
목적：계통평개열료연합화료（열화）여단순화료（단화）비교치료만기위암적료효화안전성。방법계산궤검색Cochrane Library、PubMed、EMBASE、중국생물의학문헌수거고、중국기간전문수거고、중문과기기간수거고화만방수거-수자화기간전문수거고，동시보이기타검색。수집소유비교열료연합화료여단순화료적수궤대조시험。근거Cochrane계통평개원수책5.1질량평개표준대납입문헌진행질량평개，병사용STATA SE 12.0연건진행Meta분석。결과최종납입5개수궤대조시험（351례만기위암환자）。Meta분석결과현시：재료효방면，열화조적완전완해솔[OR＝2.13，95％CI（1.17，3.86），P＝0.013]급총유효솔[OR＝1.37，95％CI（1.09，1.73），P＝0.006]균고우단화조，기차이균유통계학의의；재안전성방면，열화조여단화조적불량반응균무통계학차이。결론여단순화료상비，열료연합화료치료만기위암가명현제고완전완해솔여총유효솔，불량반응발생솔미증가。수납입연구질량화수량소한，상술결론상수개전경다고질량연구，특별시대양본、관주경다주요결국지표적수궤대조시험。추천결합환자구체정황진행림상응용。
Objective To assess the effectiveness and safety of hyperthermia combined with chemotherapy for advanced gastric cancer.Methods We searched English databases as Cochrane Library,PubMed,EMBASE and Chinese ones as CBM,CNKI,VIP and Wangfang data with com-puter and also retrieved other sources as supplying,such as tracing related references,besides we al-so communicated with authors to obtain some certain information that has not been found.All relevant randomized controlled trials (RCTs)were collected to compare hyperthermia combined with chemo-therapy and chemotherapy alone.The quality of included trials were assessed by Cochrane Handbook 5.0 for systematic reviews.Meta-analyses were conducted by STATA SE 12.0 software.Results Five RCTs involving 35 1 patients with advanced gastric cancer were included.The results of meta-analysis showed that:a)as for effectiveness,the hyperthermia combined with chemotherapy group was supe-rior to the chemotherapy group in the complete response (CR)rate (OR=2.13,95%CI 1.17 to 3.86,P =0.013)and the total efficiency rate(OR=1.37,95%CI 1.09 to 1.73,P=0.006),with significant differences;b )as for safety,the hyperthermia combined with chemotherapy group was similar to the chemotherapy group in the incidence of adverse reactions.Conclusion Compared with chemotherapy,hyperthermia combined with chemotherapy in the treatment of advanced gastric cancer can significantly improve the complete response rate and the total efficiency rate,and mean-while not increased the incidence of adverse reactions.Due to the limitation of the included studies, large sample size,multicenter,high quality studies are needed to verify the above conclusion.We recommend that chemotherapy combined with hyperthermia therapy could be applied to clinic combi-ning individual conditions of patients.