Shang Changyi, Feng Linfei, Gu Ying, Hong Houlin, Hong Lilin, Hou Jun
Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of General Dentistry, School of Dental Medicine, Stony Brook University, Stony Brook, NY, United States.
Front Oncol. 2021 Mar 8;11:630906. doi: 10.3389/fonc.2021.630906. eCollection 2021.
Head and neck cancer (HNC) is one of the more common malignant tumors that threaten human health worldwide. Multidisciplinary team management (MDTM) in HNC treatment has been introduced in the past several decades to improve patient survival rates. This study reviewed the impact of MDTM on survival rates in patients with HNC compared to conventional treatment methods. Only cohort studies were identified for this meta-analysis that included an exposure group that utilized MDTM and a control group. Heterogeneity and sensitivity also were assessed. Survival rate data for HNC patients were analyzed using RevMan 5.2 software. Five cohort studies ( = 39,070) that examined survival rates among HNC patients were included. Hazard ratios (HR) were calculated using the random effect model. The results revealed that exposure groups treated using MDTM exhibited a higher survival rate [HR = 0.84, 95% CI (0.76-0.92), = 0.0004] with moderate heterogeneity ( = 68%, = 0.01). For two studies that examined the effect of MDTM on the survival rate for patients specifically with stage IV HNC, MDTM did not produce any statistically significant improvement in survival rates [HR = 0.81, 95% CI (0.59-1.10), = 0.18]. The application of MDTM based on conventional surgery, radiotherapy, and chemotherapy improved the overall survival rate of patients with HNC. Future research should examine the efficacy of MDTM in patients with cancer at different stages.
头颈癌(HNC)是全球范围内威胁人类健康的较常见恶性肿瘤之一。在过去几十年中,头颈癌治疗引入了多学科团队管理(MDTM)以提高患者生存率。本研究回顾了与传统治疗方法相比,MDTM对HNC患者生存率的影响。本荟萃分析仅纳入了队列研究,其中包括使用MDTM的暴露组和对照组。还评估了异质性和敏感性。使用RevMan 5.2软件分析HNC患者的生存率数据。纳入了五项检验HNC患者生存率的队列研究(n = 39,070)。使用随机效应模型计算风险比(HR)。结果显示,采用MDTM治疗的暴露组生存率更高[HR = 0.84,95%CI(0.76 - 0.92),P = 0.0004],异质性中等(I² = 68%,P = 0.01)。对于两项检验MDTM对IV期HNC患者生存率影响的研究,MDTM在生存率方面未产生任何具有统计学意义的改善[HR = 0.81,95%CI(0.59 - 1.10),P = 0.18]。基于传统手术、放疗和化疗的MDTM应用提高了HNC患者的总生存率。未来研究应检验MDTM在不同癌症分期患者中的疗效。