【摘 要】
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Purpose: Concurrent chemoradiotherapy has become standard treatment for locally advanced non-small cell lung cancer(LANSCLC) in NCCN guidelines, but the guidelines is mostly based on the clinical tria
【机 构】
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Department of Radiation and Medical Oncology, Zhongnan Hospital, Wuhan University,169 Donghu Road, W
【出 处】
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第九届泛珠江区域放射肿瘤学学术大会暨肿瘤放射治疗多中心协作研讨会、重庆市医学会放射肿瘤治疗学专业委员会2014年会
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Purpose: Concurrent chemoradiotherapy has become standard treatment for locally advanced non-small cell lung cancer(LANSCLC) in NCCN guidelines, but the guidelines is mostly based on the clinical trials of Occident countries.Whether the physical differences between the patients in Occident countries and in China will lead to different efficacy and tolerance is not clear.We performed a meta-analysis of randomized controlled trials (randomized control trial, RCT) of Chinese mainland patients comparing concurrent chemoradiotherapy(concurrent platinum-based chemotherapy and radiotherapy, CRT)with radiotherapy alone (RT) to find evidence for treatment decision in Chinese mainland patients with LANSCLC.Methods: To compare the efficacy and side effects of CRT vs.RT in Chinese mainland patients with LANSCLC, We performed a meta-analysis based on the extracted data from 12 published RCTs.Those literatures were screened according to the inclusion and exclusion criteria, the quality of each research were assessed by the meta-analysis software RevMan.5.1 and GRADEprofile3.2 provided by Cochrane Collaboration.Results: Total of 12 RCTs which consist of 4 three-dimensional conformal RT (3D-CRT) and 8 two-dimensional conformal RT (2D-CRT) were included in this Meta analysis, and 943 patients with LANSCLC divided into two groups: 470 patients in RT group and 473 patients in CRT group.Concurrent chemoradiotherapy (either 3D-CRT or 2D-CRT) substantially improved the response rate (the rate of complete remission + the rate of partial remission, RR), and 1, 2, and 3-year overall survival(OS).But it increased the incidence of grade Ⅰ-Ⅳ leucopenia, nausea and vomiting, grade Ⅲ-Ⅳ radiation pneumonitis and grade Ⅲ-Ⅳ esophagitis.Conclusion: For Chinese mainland patients with LANSCLC , concurrent chemoradiotherapy (3D-CRT or 2D-CRT), as compared with radiotherapy alone, improved the rate of RR and have the OS benefit at the cost of increased incidence of leucopenia, nausea and vomiting, pneumonitis and esophagitis.
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