Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China.
J Thorac Oncol. 2010 Apr;5(4):510-6. doi: 10.1097/JTO.0b013e3181cd3345.
The survival effectiveness of neoadjuvant chemotherapy in non-small cell lung cancer (NSCLC) is still unclear based on the study of most up-to-date literatures. This article contributes to this problem by conducting an updated meta-analysis.
Based on Burdett et al's (J Thorac Oncol 2006;1:611-621) systematic review, this meta-analysis was conducted. Articles were searched electrically. The possible survival benefit of neoadjuvant chemotherapy was assessed by hazard ratio (HR) in terms of overall survival. A subgroup meta-analysis with only stage III NSCLC was also conducted. The software of Review Manager was used for data management.
Thirteen randomized control trials, 6 of which were new ones, were included into this meta-analysis. The overall survival of NSCLC patients in neoadjuvant chemotherapy arm were improved significantly, comparing with those in surgery-alone arm (combined HR = 0.84; 95% confidence interval, 0.77-0.92; p = 0.0001). When only patients with stage III NSCLC were considered, the result was similar (combined HR = 0.84; 95% confidence interval, 0.75-0.95; p = 0.005).
Neoadjuvant chemotherapy, as an addition of surgery, would significantly improve the overall survival of operable NSCLC patients, including patients with stage III NSCLC.
根据最新文献研究，新辅助化疗在非小细胞肺癌（NSCLC）中的生存效果仍不明确。本文通过更新的荟萃分析对此问题进行了探讨。
本荟萃分析基于 Burdett 等人（J Thorac Oncol 2006;1:611-621）的系统综述。通过电子检索文章。采用风险比（HR）评估新辅助化疗在总生存方面的可能生存获益。还进行了仅包括 III 期 NSCLC 的亚组荟萃分析。使用 Review Manager 软件进行数据管理。
本荟萃分析纳入了 13 项随机对照试验，其中 6 项为新试验。与单独手术组相比，新辅助化疗组 NSCLC 患者的总生存率显著提高（合并 HR = 0.84；95%置信区间，0.77-0.92；p = 0.0001）。当仅考虑 III 期 NSCLC 患者时，结果相似（合并 HR = 0.84；95%置信区间，0.75-0.95；p = 0.005）。
作为手术的附加治疗，新辅助化疗可显著提高可手术 NSCLC 患者的总生存率，包括 III 期 NSCLC 患者。
