新辅助化疗对肌层浸润性膀胱癌预后影响的Meta分析 樊晓栋，姜 庆.doc

新辅助化疗对肌层浸润性膀胱癌预后影响的Meta分析 樊晓栋，姜 庆，王家武（400016 重庆，重庆医科大学附属第二医院泌尿外科） [通信作者] 姜 庆, 电话：(023E-mail：jq001002@ [摘要] 目的 评价新辅助化疗对肌层浸润性膀胱癌患者预后的影响。 方法 通过PubMed、Cochrane library、万方、康健、CBMdisc、EMBASE等数据库收集国内外已发表的相关前瞻性随机对照研究，按预设的标准进行筛选，对纳入研究进行质量评价，并提取数据进行Meta分析。 结果 符合纳入标准的共12个研究，总样本量3286人，新辅助治疗组1636人，对照组1650人，分析结果显示新辅助化疗组与对照组相比，死亡风险优势比0.85（95%CI 0.73-0.98），P=0.03。将12个纳入研究按新辅助化疗方案进行亚组分析，单用铂剂组显示新辅助化疗并没有降低患者死亡风险，而以铂剂为基础的多药联合新辅助化疗可降低患者死亡风险（OR 0.79，95%CI 0.67-0.92，P=0.0004）。结论 新辅助化疗，尤其是以铂剂为基础的联合化疗方案，适用于肌层浸润性膀胱癌的治疗，可改善预后。 [关键词] 新辅助化疗；肌层浸润性膀胱癌；Meta分析 [中图法分类号] R694 [文献标志码] A Meta-Analysis of effect of neoadjuvant chemotherapy on prognosis of muscle-invasive bladder cancer Fan Xiaodong，Jiang Qing，Wang Jiawu(Department of Urology，The Second Affiliated Hospital of Chongqing Medical Un-iversity，Chongqing，400016，China) Abstract：Objectives To evaluate the effect of neoadjuvant chemotherapy on prognosis of muscle-invasive bladder cancer. Methods：To search and screen published prospective RCT on neoadjuvant chemotherapy for muscle-invasive bladder cancer in Pubmed，EMBASE，CBMdisc，Cochrane library and WanFang databases under preset standards. The data from eligible studies were pooled through Meta-analysis. Results：Totally 12 trials including 3286 patients were eligible to the criteria(1636 in study group and 1650 in control group).The odds radio of all trails tended to favour neoadjuvant chemotherapy (OR=0.85，95%CI 0.73-0.98，P=0.03).Platinum-based combination chemotherapy showed a significant reduc-tion in risk of death（OR 0.7995%CI 0.67-0.92，P=0.0004），but there was no evidence to support the use of single-agent platinum. Conclusions：Neoadjuvant chemotherapy especiallylatinum-based combination chemotherapy is beneficial to muscle-invasive bladder cancer patients. [Key words] neoadjuvant chemotherapy；muscle-invasive bladder cancer；Meta-nalysis Corresponding author: Jiang Qing， Tel:23 E-mail: jq001002@ 膀胱癌是泌尿系统最常见的恶性肿瘤发病率居泌尿系统恶性肿瘤的首位。preoperative chemother