CAJ | 학술논문

目的：系统分析进展期胃癌根治术后辅助化疗对患者生存期的影响。方法通过检索CNKI、PubMed、Elsevier电子期刊、Springer电子期刊、Oxford电子期刊获取2003年1月至2013年12月来国内外公开发表的相关文献，收集以术后辅助化疗与单纯手术比较的前瞻性随机对照研究共11篇，使用Cochrane协作网提供的统计软件RevManager 5．2对效应量进行合并，对总生存期、无病生存期、无复发生存期方面进行定量系统评价。结果共纳入11篇前瞻性随机对照文献，Jadad量表评分均4分及以上，共4433例患者，其中手术加术后化疗为2203例，单纯手术为2230例，结果分析提示术后辅助化疗使患者生存期明显获益，差异有统计学意义。OS ：HR＝0．80，95％ CI（0．73，0．88），P＜0．01；DFS ：HR＝0．78，95％ CI（0．63，0．97），P＝0．02；RFS ：HR＝0．67，95％ CI（0．53，0．85），P＝0．001。结论术后辅助化疗能使胃癌根治术后患者总生存期明显获益，D2根治术后给予口服卡培他滨联合奥沙利铂或口服单药替吉奥辅助化疗可能是目前最佳方案。
목적：계통분석진전기위암근치술후보조화료대환자생존기적영향。방법통과검색CNKI、PubMed、Elsevier전자기간、Springer전자기간、Oxford전자기간획취2003년1월지2013년12월래국내외공개발표적상관문헌，수집이술후보조화료여단순수술비교적전첨성수궤대조연구공11편，사용Cochrane협작망제공적통계연건RevManager 5．2대효응량진행합병，대총생존기、무병생존기、무복발생존기방면진행정량계통평개。결과공납입11편전첨성수궤대조문헌，Jadad량표평분균4분급이상，공4433례환자，기중수술가술후화료위2203례，단순수술위2230례，결과분석제시술후보조화료사환자생존기명현획익，차이유통계학의의。OS ：HR＝0．80，95％ CI（0．73，0．88），P＜0．01；DFS ：HR＝0．78，95％ CI（0．63，0．97），P＝0．02；RFS ：HR＝0．67，95％ CI（0．53，0．85），P＝0．001。결론술후보조화료능사위암근치술후환자총생존기명현획익，D2근치술후급여구복잡배타빈연합오사리박혹구복단약체길오보조화료가능시목전최가방안。
Objective To systematically analyze the effect of adjuvant chemotherapy after radical operation in advanced gastric cancer .Methods The related literatures published at home and abroad were retrieved from the electronic databases including CNKI ,PubMed ,Elsevier ,Springer ,Oxford from January 2003 to December 2013 ,then 11 articles of the randomized controlled trial (RCT) of the comparison between the postoperative adjuvant chemotherapy and simple operation were collected .The effect merging and the quantitative systematic evaluation in the aspects of the total survival ,disease free survival and relapse free survival were per-formed with RevMan5 .2 provided by the Cochrane collaboration network .Results 11 articles of RCT were included with 4 points and more by the Jadad scale ,involving 4 433 patients ,among them 2 203 patients with operation plus postoperative chemotherapy and 2 230 patients with surgery alone .The results analysis indicated that the postoperative adjuvant chemotherapy made the pa-tients to obtain the apparent benefit during survival period ,the significant difference had statistical significance .OS :HR= 0 .80 , 95% CI(0 .73 ,0 .88) ,P<0 .01 ;DFS :HR=0 .78 ,95% CI(0 .63 ,0 .97) ,P=0 .02 ;RFS :HR=0 .67 ,95% CI(0 .53 ,0 .85) ,P=0 .001 . Conclusion The postoperative adjuvant chemotherapy can make the patients with radical operation to obtain the apparent benefit during the survival period .The adjuvant chemotherapy of oral capecitabine plus oxaliplatin or oral Tegafur Gimeracil Oteracil Potas-sium after D2 radical operation may be the best scheme at present .