摘要
目的:探讨腹腔化疗在进展期胃癌治疗中的作用.方法:利用Meta分析的方法,对国内外已发表的12篇随机对照研究进行定量综合,应用Cochrane协作网提供的RevMan4.2软件进行统计分析,以OR值作为结局变量.结果:人选的12篇文献,共有患者1249例.合计OR=0.53,95%置信区间(0.42-0.67),说明了腹腔化疗优势明显.亚组分析表明,对于来自亚洲、进行腹腔温热化疗或含活性碳粒的腹腔内化疗的患者,效果尤为突出.敏感性分析与失效安全数计算证实本结论较为可靠.但仅有试验4个质量较高,使得研究结论的证据力度有所降低.结论:进展期胃癌根治术后行腹腔化疗可能对患者有益.
Abstract
AIM: To assess the role of intraperitoneal chemo-therapy( IPT) in patients with gastric carcinoma after radial resection. METHODS: We reviewed 12 randomized controlled trials about IPT in local advanced gastric cancer and made a meta-anal-ysis. The statistical analysis was performed by RevMan4. 2 software provided by the Cochrane Collaboration. The result was expressed with odds ratio ( OR) for the categorical variable. RESULTS: Twelve trials of 1249 cases were included. The pooled OR was 0. 53, with a 95% confidence interval ( 0. 42-0.67), showing the favorable effect of IPT. Subgroup analysis showed good effect of IPT especially to Asian patients treated with intraperitoneal hyperthermic chemoperfusion ( IHCP) or chemotherapy with activated carbon particles (CH). Sensitivity analysis and fail-safe number suggested that the result of this study was comparatively reliable, but there exist some limitations due to the relatively small number of high-quality trials under study(4/12). CONCLUSION: IPT after curative resection of local advanced gastric cancer may be beneficial to patients.
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维普
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