目的 对比同步放化疗联合或不联合抗EGFR药物对局部晚期食管癌患者的疗效.方法 检索PubMed、Embase、Cochrane Library Web of Science、中国知网(CNKI)、维普中文期刊、万方医学期刊,筛选并纳入符合标准的文献,采用RevMan 5.4.1统计软件对纳入的相关研究进行异质性检验,并选择相应的效应模型,对效应值HR进行合并,绘制漏斗图评估发表性偏倚.结果 纳入文献8篇,10组临床对照实验,累计样本量1 806例患者,其中实验组896例,对照组910例.分析结果显示同步放化疗联合靶向药物在患者OS方面差异无统计学意义(HR=0.87,95%CI:0.72~1.06,P=0.17),厄洛替尼联合同步放化疗可明显改善患者的OS(HR=0.72,95%CI:0.62~0.83,P<0.0001),西妥昔单抗联合同步放化疗在OS上差异无统计学意义(HR=1.05,95%CI:0.78-1.41,P=0.77).结论 对于晚期食管癌患者,同步放化疗联合厄洛替尼能明显改善患者的OS,生存获益显著.
Objective To compare the efficacy of concurrent chemoradiotherapy with or without anti-EG-FR drugs in patients with locally advanced esophageal cancer.Methods PubMed,Embase,Cochrane Li-brary,Web of Science,CNKI,VIP,Wanfang were retrieved,and the literatures that meet the standards were screened and included.RevMan5.4.1 statistical software was used to test the heterogeneity of studies,and the corresponding effect models were selected to merge the effect values,and funnel plots were drawn to eval-uate the publication bias.Results 8 articles and 10 groups of controlled clinical trials were included,in-volving a sample size of 1806 patients,including 896 in the experimental group and 910 in the control group.The analysis results showed that there was no significant difference in OS of patients with concurrent chemora-diotherapy combined with targeted drugs(HR=0.87,95%CI:0.72~1.06,P=0.17),erlotinib combined with concurrent chemoradiotherapy significantly improved the OS of patients(HR=0.72,95%CI:0.62-0.83,P<0.0001),while cetuximab combined with concurrent chemoradiotherapy had no significant differ-ence in OS(HR=1.05,95%CI:0.78~1.41,P=0.77).Conclusion For patients with advanced esopha-geal cancer,concurrent chemoradiotherapy combined with erlotinib can significantly improve the OS of pa-tients and have significant survival benefits.