在局部晚期结肠癌的新辅助化疗:一个系统的审查与比例的元分析
K van den Berg1, I E G van Hellemond2, J M W E Willems3
1Department of Medical Oncology, Catharina Hospital, Eindhoven, Netherlands; Department of Surgery, Catharina Hospital, Eindhoven, Netherlands.
概括
针对局部晚期结肠癌的新辅助化疗显示安全性,但缺乏长期结果数据. 它可能有利于选择患者,但过度治疗的风险需要仔细考虑.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 新辅助化疗被认为是局部先进的结肠癌.
- 缺乏长期瘤结果数据阻碍了临床实践的实施.
研究的目的:
- 系统地审查新辅助化疗在局部晚期结肠癌中的益处和缺点.
- 根据可用的文献,提供短期和长期结果的概述.
主要方法:
- 在Embase,MEDLINE和Cochrane图书馆进行系统的文献搜索.
- 包括可操作,局部晚期结肠癌没有转移的研究.
- 使用MedCalc统计软件进行的比例元分析.
主要成果:
- 包括17项研究 (3项RCT,其他14项).
- 手术前退学率<7.8%; 组织病理学完全响应率0-4.8%.
- 在新辅助和前期手术组中,解剖管漏率<8%.
结论:
- 新辅助化疗是辅助化疗的安全替代方案,可以帮助治疗术前的结果.
- 缺乏可靠的长期生存数据.
- 在选择局部晚期结肠癌患者中考虑新辅助化疗,因为过度治疗的担忧.
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