Li Ranhua, Yang Guixue, Tian Ye, Tian Dali
Department of Thoracic Surgery, the Fourth Affiliated Hospital of China Medical University, Shenyang 110000, China.
J Thorac Dis. 2019 Jul;11(7):3047-3054. doi: 10.21037/jtd.2019.07.47.
The aim of this meta-analysis was to compare the benefits of postoperative adjuvant chemotherapy vs. observation for stage IB non-small cell lung cancer (NSCLC).
A literature search was performed in PubMed, Embase, and Cochrane Library databases, and stage IB NSCLC patients were assigned to the postoperative adjuvant chemotherapy and observation groups. The 5-year overall survival (OS), 5-year disease-free survival (DFS), local recurrence, and distant metastasis were then assessed. In addition, statistical analysis was conducted using Review Manager 5.3 software.
The meta-analysis involved nine articles and included 1,645 stage IB patients. There was no significance in the 5-year OS [relative risk (RR) =1.05; 95% confidence interval (CI): 0.98-1.13; P=0.14] and 5-year DFS (RR =1.29; 95% CI: 0.97-1.72; P=0.08) between the postoperative adjuvant chemotherapy and observation groups. However, there was a significant difference in local recurrence (RR =0.43; 95% CI: 0.23-0.80; P=0.007) and distant metastasis (RR =0.68; 95% CI: 0.48-0.97; P=0.03) between the two groups.
Adjuvant chemotherapy might not be recommended for stage IB NSCLC.
本荟萃分析旨在比较术后辅助化疗与观察对于ⅠB期非小细胞肺癌（NSCLC）的益处。
在PubMed、Embase和Cochrane图书馆数据库中进行文献检索，将ⅠB期NSCLC患者分为术后辅助化疗组和观察组。然后评估5年总生存期（OS）、5年无病生存期（DFS）、局部复发和远处转移情况。此外，使用Review Manager 5.3软件进行统计分析。
该荟萃分析纳入9篇文章，共1645例ⅠB期患者。术后辅助化疗组与观察组在5年OS（相对危险度[RR]=1.05；95%置信区间[CI]：0.98-1.13；P=0.14）和5年DFS（RR=1.29；95%CI：0.97-1.72；P=0.08）方面无显著差异。然而，两组在局部复发（RR=0.43；95%CI：0.23-0.80；P=0.007）和远处转移（RR=0.68；95%CI：0.48-0.97；P=0.03）方面存在显著差异。
对于ⅠB期NSCLC，可能不推荐辅助化疗。
