- 胃癌术后辅助化疗可提高生存率
- 作者：傅敬忠|发布时间：2013-06-21|浏览量：3182次
胃癌术后辅助化疗可提高生存率
paoletti x,et al最近一项荟萃分析显示，与仅接受手术的患者相比，那些在胃癌术后跟着接受化疗的患者与其死亡风险的下降以及无病生存率的提高有关。研究论文5月5日发表于《美国医学会杂志》
胃癌是一种常见而且高度致命的疾病，其目前的5年生存率低于20%。法国国立癌症研究所的
研究者写道：“总之，这一患者层面上的荟萃分析显示，辅助性的以氟尿嘧啶为基础的化疗，甚至那些使用单个药物的化疗，都与总体生存率的改善有关，因此建议那些在其胃癌全切除之后没有接受手术前后治疗的患者使用辅助性化疗。基于所收集数据的未来的报告将探索预后因子以及以无病生存替代这一群体的总体生存的做法。”
相关链接:benefit of adjuvant chemotherapy for resectable gastric cancer
benefit of adjuvant chemotherapy for resectable gastric cancer: a meta-analysis.
jama. 2010 may 5;303(17):1729-37
authors: , paoletti x, oba k, burzykowski t, michiels s, ohashi y, pignon jp, rougier p, sakamoto j, sargent d, sasako m, van cutsem e, buyse m
context: despite potentially curative resection of stomach cancer, 50% to 90% of patients die of disease relapse. numerous randomized clinical trials (rcts) have compared surgery alone with adjuvant chemotherapy, but definitive evidence is lacking. objectives: to perform an individual patient-level meta-analysis of all rcts to quantify the potential benefit of chemotherapy after complete resection over surgery alone in terms of overall survival and disease-free survival, and to further study the role of regimens, including monochemotherapy; combined chemotherapy with fluorouracil derivatives, mitomycin c, and other therapies but no anthracyclines; combined chemotherapy with fluorouracil derivatives, mitomycin c, and anthracyclines; and other treatments. data sources: data from all rcts comparing adjuvant chemotherapy with surgery alone in patients with resectable gastric cancer. we searched medline (up to 2009), the cochrane central register of controlled trials, the national institutes of health trial registry, and published proceedings from major oncologic and gastrointestinal cancer meetings. study selection: all rcts closed to patient recruitment before 2004 were eligible. trials testing radiotherapy; neoadjuvant, perioperative, or intraperitoneal chemotherapy; or immunotherapy were excluded. thirty-one eligible trials (6390 patients) were identified. data extraction: as of 2010, individual patient data were available from 17 trials (3838 patients representing 60% of the targeted data) with a median follow-up exceeding 7 years. results: there were 1000 deaths among 1924 patients assigned to chemotherapy groups and 1067 deaths among 1857 patients assigned to surgery-only groups. adjuvant chemotherapy was associated with a statistically significant benefit in terms of overall survival (hazard ratio [hr], 0.82; 95% confidence interval [ci], 0.76-0.90; p < .001) and disease-free survival (hr, 0.82; 95% ci, 0.75-0.90; p < .001). there was no significant heterogeneity for overall survival across rcts (p = .52) or the 4 regimen groups (p = .13). five-year overall survival increased from 49.6% to 55.3% with chemotherapy. conclusion: among the rcts included, postoperative adjuvant chemotherapy based on fluorouracil regimens was associated with reduced risk of death in gastric cancer compared with surgery alone.
pmid: 20442389 [pubmed - in process]
