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ASCO 2014:局部晚期非小细胞肺癌同步放化疗未增加治疗相关性死亡

2014-05-31 Ruanancy 译 医学论坛网

摘要号:#7561研究标题:局部晚期非小细胞肺癌患者同步放化疗后的治疗相关性死亡:随机化研究的荟萃分析第一作者:Zhao Jing ,华中科技大学同济医学院附属同济医院背景:治疗相关性死亡(TRDs)是与肿瘤进展无关的一种5级事件,可在局部晚期非小细胞肺癌(NSCLC)患者接受同步放化疗(cCRT)后发生。本研究的目的是:1)比较cCRT与非cCRT(序贯放化疗或单纯放疗)治疗的患者之间的TRDs

摘要号:#7561

研究标题:局部晚期非小细胞肺癌患者同步放化疗后的治疗相关性死亡:随机化研究的荟萃分析

第一作者:Zhao Jing ,华中科技大学同济医学院附属同济医院

背景:治疗相关性死亡(TRDs)是与肿瘤进展无关的一种5级事件,可在局部晚期非小细胞肺癌(NSCLC)患者接受同步放化疗(cCRT)后发生。本研究的目的是:1)比较cCRT与非cCRT(序贯放化疗或单纯放疗)治疗的患者之间的TRDs率; 2)确定辐射剂量和化疗方案是否是与cCRT治疗后TRDs相关的独立危险因素。

方法:符合条件的研究包括1999年1月1日至2013年11月30日期间所报告的针对局部晚期非小细胞肺癌患者进行的一些随机对照试验(含有cCRT治疗组和TRDs数据);采用对数秩检验和固定效应模型计算集中风险比(HR s);利用Χ2检验和I2研究试验间的异质性。

结果:符合要求的研究有28项(5897例患者)。接受cCRT和非cCRT治疗的患者的TRD率分别为3.0%和3.7%(P=0.313)。单因素分析显示,辐射剂量(> 60Gy)、用于cCRT的药物数量(大于1种)、cCRT(不包括依托泊苷+顺铂)或巩固性化疗的方案与TRDs并没有显著相关性。在9项对比cCRT与非cCRT之间TRD的试验中, 两组间TRD的HR为1.22(95%CI:0.72-2.06,P=0.455 )。异质性检验不具有显著性(Χ2 = 9.62,P=0.38, I2 = 6%)。这28项试验中有4项试验被用来分析TRDs与剂量分次方法之间的相关性;合并数据后,经标准分级辐射与超分次放射治疗后的TRDs之间没有显著差异(HR=0.99,95%CI:0.46-2.13,P=0.977)。化疗药物的选择(第三代化疗方案或其他方案)和巩固性化疗或无巩固性化疗(各有4项相关试验)对TRD率都没有显著影响。

结论:与序贯放化疗或单纯放疗相比,cCRT并没有显著增加TRD;无论是放射剂量还是化疗方案都不会增加治疗死亡率。

研究链接:Treatment-related deaths after concurrent chemoradiotherapy in locally advanced non-small cell lung cancer: A meta-analysis of randomized studies. (Abstract 7561)

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    2014-07-01 quxin068
  5. [GetPortalCommentsPageByObjectIdResponse(id=2059465, encodeId=4f9a2059465cd, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, encryptionId=2cc599381bd, topicName=非小细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Jun 12 17:21:00 CST 2014, time=2014-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650702, encodeId=31521650e026b, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Thu Jul 24 02:21:00 CST 2014, time=2014-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1837144, encodeId=e87e183e144d5, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Sun Nov 30 07:21:00 CST 2014, time=2014-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938313, encodeId=7bd919383137d, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Tue Jul 01 01:21:00 CST 2014, time=2014-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1287864, encodeId=4aaf128e864c5, content=<a href='/topic/show?id=4d185e31825' target=_blank style='color:#2F92EE;'>#放化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57318, encryptionId=4d185e31825, topicName=放化疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=310e209, createdName=yzh399, createdTime=Mon Jun 02 12:21:00 CST 2014, time=2014-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405655, encodeId=d8301405655cc, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Mon Jun 02 12:21:00 CST 2014, time=2014-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516664, encodeId=cac015166648b, content=<a href='/topic/show?id=a8183896891' target=_blank style='color:#2F92EE;'>#同步放化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38968, encryptionId=a8183896891, topicName=同步放化疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c1dd10999249, createdName=12498e0fm81暂无昵称, createdTime=Mon Jun 02 12:21:00 CST 2014, time=2014-06-02, status=1, ipAttribution=)]
    2014-06-02 yzh399
  6. [GetPortalCommentsPageByObjectIdResponse(id=2059465, encodeId=4f9a2059465cd, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, encryptionId=2cc599381bd, topicName=非小细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Jun 12 17:21:00 CST 2014, time=2014-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1650702, encodeId=31521650e026b, content=<a href='/topic/show?id=ffae4e614b6' target=_blank style='color:#2F92EE;'>#局部晚期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47614, encryptionId=ffae4e614b6, topicName=局部晚期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=901d24099859, createdName=yhy100208, createdTime=Thu Jul 24 02:21:00 CST 2014, time=2014-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1837144, encodeId=e87e183e144d5, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Sun Nov 30 07:21:00 CST 2014, time=2014-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938313, encodeId=7bd919383137d, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Tue Jul 01 01:21:00 CST 2014, time=2014-07-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1287864, encodeId=4aaf128e864c5, content=<a href='/topic/show?id=4d185e31825' target=_blank style='color:#2F92EE;'>#放化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57318, encryptionId=4d185e31825, topicName=放化疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=310e209, createdName=yzh399, createdTime=Mon Jun 02 12:21:00 CST 2014, time=2014-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405655, encodeId=d8301405655cc, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Mon Jun 02 12:21:00 CST 2014, time=2014-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516664, encodeId=cac015166648b, content=<a href='/topic/show?id=a8183896891' target=_blank style='color:#2F92EE;'>#同步放化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38968, encryptionId=a8183896891, topicName=同步放化疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c1dd10999249, createdName=12498e0fm81暂无昵称, createdTime=Mon Jun 02 12:21:00 CST 2014, time=2014-06-02, status=1, ipAttribution=)]
    2014-06-02 chg122
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