辅助化疗在胆道癌患者中的应用：一项随机对照试验的系统评价和荟萃分析。
Adjuvant chemotherapy in biliary tract cancer patients: A systematic review and meta-analysis of randomized controlled trials.
机构信息
Department of Medical Oncology, Institut Jules Bordet and Université Libre de Bruxelles (ULB), Brussels, Belgium.
Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
出版信息
Crit Rev Oncol Hematol. 2020 May;149:102940. doi: 10.1016/j.critrevonc.2020.102940. Epub 2020 Mar 19.
BACKGROUND
The role of adjuvant chemotherapy in biliary tract cancer is controversial. We performed a systematic review and meta-analysis to assess the effect of adjuvant chemotherapy in biliary tract cancer patients.
METHODS
A literature search was performed to identify randomized controlled trials (RCTs) comparing adjuvant chemotherapy versus observation, and a pooled analysis was conducted using the random-effect model.
RESULTS
Three RCTs (N = 866) were included. No difference was observed between chemotherapy and observation in terms of OS (HR 0.91; 95 %CI, 0.75-1.09; p = 0.295), whereas a significant improvement in RFS was shown (HR 0.83; 95 %CI, 0.69-0.99; p = 0.040). No subgroup that benefited most from adjuvant chemotherapy was identified, although a trend was observed in N+ patients (HR 0.83; 95 %CI, 0.65-1.08; p = 0.165).
DISCUSSION
Adjuvant chemotherapy yields a significant RFS benefit in biliary tract cancer patients and should be considered for those who are able to tolerate additional treatment after surgery.
背景
辅助化疗在胆管癌中的作用存在争议。我们进行了系统评价和荟萃分析，以评估辅助化疗对胆管癌患者的疗效。
方法
进行了文献检索，以确定比较辅助化疗与观察的随机对照试验（RCT），并使用随机效应模型进行汇总分析。
结果
纳入了 3 项 RCT（N=866）。化疗与观察在 OS 方面无差异（HR 0.91；95%CI，0.75-1.09；p=0.295），但 RFS 显著改善（HR 0.83；95%CI，0.69-0.99；p=0.040）。虽然在 N+患者中观察到一种趋势，但未确定最能从辅助化疗中获益的亚组（HR 0.83；95%CI，0.65-1.08；p=0.165）。
讨论
辅助化疗可使胆管癌患者获得显著的 RFS 获益，对于那些能够耐受术后额外治疗的患者应考虑使用。
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