论文部分内容阅读
目的 系统评价术后辅助放疗对胸腺瘤完整切除患者的有效性.方法 计算机检索MEDLINE、EMbase、PubMed、中国知网、维普数据库、万方数据库和The Cochrane Library数据库,检索时限均为从建库至2015年8月,纳入有关术后辅助放疗治疗胸腺瘤的文献.由两名研究者按照纳入与排除标准独立筛选文献、提取资料和评价文献质量后,采用RevMan 5.3软件进行Meta分析.结果 共纳入14个研究,3823例患者,其中2096例患者接受了术后辅助放疗,1727例患者只接受了胸腺完整切除术.Meta分析结果显示:相对于单纯行胸腺瘤完整切除术的患者,术后辅助放疗未提高明显患者的总体生存率(OS)[HR=0.99,95﹪CI 0.87~1.13,P=0.87]、无病生存率[HR=1.21,95﹪CI 0.97~1.51,P=0.09]和疾病特异生存率[HR=0.66,95﹪CI 0.39~1.13,P=0.13];但亚组分析显示,在提高患者OS方面,对于Ⅱ期和Ⅲ期胸腺瘤患者,术后辅助放疗可使患者获益,HR和95﹪CI分别为0.57,0.41~0.80(P=0.001)和0.73、0.59~0.90(P=0.004).结论 胸腺瘤完整切除术后辅助放疗可提高Ⅱ期和Ⅲ期胸腺瘤患者的OS.“,”Objective To systematically evaluate the efficacy of postoperative radiotherapy in patients with completely resected thymoma .Methods Literature about the efficacy of postoperative radiotherapy in patients with completely resected thymoma were searched from digital databases of MEDLINE , EMbase, PubMed, CNKI, VIP, WanFang Data and The Cochrane Library from their establishment dates to August 2015.Data extraction and quality assessment of included studies were conducted by two reviewers independently .RevMan 5.3 software was then used to perform Meta-analysis.Results A total of 14 studies involving 3823 patients(2096 patients who received postoperative radiotherapy and 1727 patients who did not receive postoperative radiotherapy ) were included in the analysis .The results of Meta-analysis showed that , thymoma patients who receive postoperative radiotherapy did not have significantly improved overall survial ( OS) ( HR=0.99,95﹪CI 0.87-1.13,P=0.87),disease-free survival (HR=1.21,95﹪CI 0.97-1.51,P=0.09),or disease specific survival (HR=0.66,95﹪CI 0.39-1.13,P=0.13) compared with the patients who did not undergo postoperative radiotherapy .However,our subgroup analysis showed a significant difference in OS in patients with stage Ⅱthymoma(HR=0.57,95﹪CI 0.41-0.80,P=0.001) and patients with stageⅢthymoma(HR=0.73,95﹪CI 0.59-0.90,P=0.004).Conclusion In the aspect of OS, the postoperative radiotherapy is beneficial to the patients with stage ⅡandⅢthymoma after a complete resection .