Fan J M, Wen S X, Wang B Q, Huangfu H, Zhai X S, Zhao X J
the First Clinical College of Shanxi Medical University, Taiyuan 030001, China（Fan Jiamin is working on the Department of Otorhinolaryngology Head and Neck Surgery, Datong Coal Mine Group General Hospital, Datong 037000, China）.
Department of Otorhinolaryngology Head and Neck Surgery, the First Hospital of Shanxi Medical University, Taiyuan. 030001, China （Wen Shuxin is working on the Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen University, General Hospital, Shenzhen 518055, China）.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Feb 7;55(2):144-149. doi: 10.3760/cma.j.issn.1673-0860.2020.02.011.
Meta-analysis was used to compare the long-term efficacy and laryngeal function preservation rate of patients with advanced hypopharyngeal cancer treated with surgery plus radio(chemo)therapy (SRT) or non-surgery chemoradiotherapy (CRT). We searched publicly published articles on case-control studies of surgical and non-surgical comprehensive treatment of advanced hypopharyngeal cancer in PubMed, the Cochrane Library, Wanfang Database, Chinese Journal Full-text Database, and Chinese Science and Technology Periodical Database. The search language was limited to Chinese and English, and the period was from 1990 to 2018. These literatures were rigorously screened by inclusion and exclusion criteria. The data needed for this study were extracted and the Meta analysis was performed using RevMan 5.3 software. A total of 13 literatures were included, and the overall quality of the literature was relatively high, and no significant publication bias was suggested. A total of 1 994 subjects, including 720 in the SRT group and 1 274 in the CRT group. The average 3-year overall survival rates were 42.9% in SRT group and 44.8% in CRT group,with no significant difference (1.14, 95: 0.62-2.06, 0.68). The average 5-year overall survival rate (1.42, 95: 1.10-1.84, 0.01), 5-year local recurrence-free survival rate (1.68, 95: 1.11-2.55, 0.01) and 5-year local control rate (2.17, 95: 1.52-3.12, 0.01) of SRT group were 46.4%, 47.4% and 71.2%, respectively, which were higher than those of non-surgical group (37.9%, 32.0%, and 52.2% respectively). The average laryngeal function preservation rate was 19.8%,being significantly lower than 80.6% of the non-surgical group(0.03, 95: 0.01-0.07, 0.01). SRT has better long-term efficacy, while CRT has better preservation of laryngeal function.
采用Meta分析比较手术加放（化）疗（SRT）与非手术放化疗（CRT）治疗晚期下咽癌患者的长期疗效及喉功能保留率。我们检索了PubMed、Cochrane图书馆、万方数据库、中国期刊全文数据库和中国科技期刊数据库中关于晚期下咽癌手术与非手术综合治疗的病例对照研究的公开文献。检索语言限于中文和英文，时间范围为1990年至2018年。这些文献通过纳入和排除标准进行严格筛选。提取本研究所需的数据，并使用RevMan 5.3软件进行Meta分析。共纳入13篇文献，文献总体质量较高，未提示明显的发表偏倚。共1994例受试者，其中SRT组720例，CRT组1274例。SRT组平均3年总生存率为42.9%，CRT组为44.8%，差异无统计学意义（1.14，95%CI：0.62 - 2.06，P = 0.68）。SRT组平均5年总生存率（1.42，95%CI：1.10 - 1.84，P = 0.01）、5年无局部复发生存率（1.68，95%CI：1.11 - 2.55，P = 0.01）和5年局部控制率（2.17，95%CI：1.52 - 3.12，P = 0.01）分别为46.4%、47.4%和71.2%，均高于非手术组（分别为37.9%、32.0%和52.2%）。平均喉功能保留率为19.8%，显著低于非手术组的80.6%（0.03，95%CI：0.01 - 0.07，P = 0.01）。SRT长期疗效较好，而CRT对喉功能的保留较好。
