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手术联合化疗与单纯化疗治疗原发性肠道淋巴瘤的Meta 分析。

Surgery plus chemotherapy versus chemotherapy alone in primary intestinal lymphoma: a meta-analysis.

机构信息

Department of Medical Oncology, 499809Hangzhou Cancer Hospital, Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Department of Oncology and Hematology, Zhejiang Provincial Integrated Chinese and Western Medicine Hospital (Hangzhou Red Cross Hospital), Hangzhou, China.

出版信息

J Int Med Res. 2021 Nov;49(11):3000605211056845. doi: 10.1177/03000605211056845.

DOI:10.1177/03000605211056845
PMID:34763562
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8593296/
Abstract

OBJECTIVE

Primary intestinal lymphomas (PILs) are uncommon tumors, but their incidence is increasing. Currently, their management is centered around systemic treatments, such as chemotherapy and radiotherapy, whereas surgery is restricted to selected indications. This meta-analysis aimed to evaluate the role of surgery in PIL treatment.

METHODS

We collected publications comparing surgery plus chemotherapy versus chemotherapy alone in patients with PIL from 2000 to 2021. All trials analyzed the summary odds ratios (ORs) of endpoints, including the 5-year overall survival (OS), 3-year OS, and 3-year progression-free survival rates. Combined pooled ORs were analyzed using fixed- or random-effects models according to heterogeneity.

RESULTS

Six studies were included. Compared with chemotherapy alone, surgery plus chemotherapy was associated with significantly higher 5-year OS [OR = 4.88, 95%confidence interval (CI) = 1.91-12.44, Z = 3.32], 3-year OS (OR = 3.83, 95%CI = 2.33-6.30, Z = 5.30), and 3-year progression-free survival (OR = 3.51, 95%CI = 2.20-5.58, Z = 5.29).

CONCLUSIONS

Surgery plus chemotherapy was associated with better outcomes than chemotherapy alone, especially in the early stages. Therefore, surgery plus chemotherapy may be the preferred strategy for appropriately selected patients with PIL.The protocol for this systematic review was registered at INPLASY (INPLASY202180102) and is available in full (https: //doi.org/10.37766/inplasy2021.8.0102).

摘要

目的

原发性肠道淋巴瘤（PIL）是一种罕见的肿瘤，但发病率正在上升。目前，其治疗以全身治疗为主，如化疗和放疗，而手术仅限于特定的适应证。本荟萃分析旨在评估手术在 PIL 治疗中的作用。

方法

我们收集了 2000 年至 2021 年比较手术联合化疗与单纯化疗治疗 PIL 患者的文献。所有试验均分析了终点的汇总优势比（OR），包括 5 年总生存率（OS）、3 年 OS 和 3 年无进展生存率。根据异质性，采用固定或随机效应模型分析联合汇总 OR。

结果

纳入 6 项研究。与单纯化疗相比，手术联合化疗可显著提高 5 年 OS [OR=4.88，95%置信区间（CI）=1.91-12.44，Z=3.32]、3 年 OS（OR=3.83，95%CI=2.33-6.30，Z=5.30）和 3 年无进展生存率（OR=3.51，95%CI=2.20-5.58，Z=5.29）。

结论

手术联合化疗的效果优于单纯化疗，特别是在早期阶段。因此，手术联合化疗可能是 PIL 患者的首选治疗策略。本系统评价的方案已在 INPLASY（INPLASY202180102）中注册，并可在全文中查阅（https://doi.org/10.37766/inplasy2021.8.0102）。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/a12ac72d8944/10.1177_03000605211056845-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/ee01b18670e4/10.1177_03000605211056845-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/a965bf8e8732/10.1177_03000605211056845-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/8a03b804538d/10.1177_03000605211056845-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/8c0e7ca85ada/10.1177_03000605211056845-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/c438f2cd2d09/10.1177_03000605211056845-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/a12ac72d8944/10.1177_03000605211056845-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/ee01b18670e4/10.1177_03000605211056845-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/a965bf8e8732/10.1177_03000605211056845-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/8a03b804538d/10.1177_03000605211056845-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/8c0e7ca85ada/10.1177_03000605211056845-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/c438f2cd2d09/10.1177_03000605211056845-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a75/8593296/a12ac72d8944/10.1177_03000605211056845-fig6.jpg

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