Shang Jinbiao, Gu Jialei, Han Qianbo, Xu Yaping, Yu Xinmin, Wang Kejin
Department of Head and Neck Surgery, Zhejiang Cancer Hospital Hangzhou 310022, China ; Wenzhou Medical University Wenzhou 325035, China.
Wenzhou Medical University Wenzhou 325035, China ; Department of Radiation Oncology, Zhejiang Cancer Hospital Hangzhou 310022, China.
Int J Clin Exp Med. 2014 Sep 15;7(9):2478-87. eCollection 2014.
To conduct a comprehensive review whether chemotherapy to radiotherapy after surgical resection could improve the loco regional control and survival compared with postoperative radiotherapy alone.
A comprehensive search of PubMed for relevant studies comparing patients with advanced squamous cell carcinoma of the head and neck undergoing chemoradiotherapy or radiotherapy alone after resection was conducted.
The meta-analysis demonstrated significant benefits from adding chemotherapy to radiotherapy in local-regional control, disease-free survival and overall survival (p < 0.00001). The adverse effects include hematological and non-hematological toxicities. Although the acute and late toxicities occurred more frequently and severely in chemoradiation combined treatment, there was no significant difference compared with radiotherapy alone, but the estimated pooled RR of mucositis or dysphagia was 1.69 (p < 0.00001) in favor of radiotherapy regimens.
Postoperative chemotherapy adding to radiotherapy is superior to radiotherapy alone. Patients with chemoradiotherapy after surgical resection can achieve the higher LRC, longer DFS and OS.
进行一项全面综述,以探讨手术切除后化疗联合放疗与单纯术后放疗相比是否能改善局部区域控制和生存率。
对PubMed进行全面检索,以查找比较头颈部晚期鳞状细胞癌患者在切除后接受放化疗或单纯放疗的相关研究。
荟萃分析表明,放疗联合化疗在局部区域控制、无病生存期和总生存期方面具有显著益处(p < 0.00001)。不良反应包括血液学和非血液学毒性。虽然放化疗联合治疗中急性和晚期毒性发生频率更高且更严重,但与单纯放疗相比无显著差异,但黏膜炎或吞咽困难的估计合并相对危险度为1.69(p < 0.00001),支持放疗方案。
术后化疗联合放疗优于单纯放疗。手术切除后接受放化疗的患者可实现更高的局部区域控制率、更长的无病生存期和总生存期。