目的 系统评价热疗联合放疗或放化疗治疗原发性鼻咽癌及其颈淋巴结转移的疗效及安全性. 方法 计算机检索 Cochrane 图书馆, PubMed, EMBASE, Web of Science, 中国生物医学文献数据库, 中国学术期刊网络出版总库, 维普中文科技期刊数据库和万方数字化期刊全文数据库八大数据库, 同时辅以其他检索, 收集所有热疗综合疗法治疗鼻咽癌的随机对照试验. 文献筛选, 资料提取和质量评价后, 使用 RevMan5. 1 软件进行 Meta 分析. 结果 共纳入 21 篇随机对照研究 (1 680 例患者). Meta 分析结果显示: ① 原发灶热放组的完全缓解率比值比 3.13, 95% 可信区间 (2.00, 4.92) 和总有效率比值比 6.84, 95% 可信区间 (1.48, 31.60) 均显著好于单放组, 且其差异均有统计学意义 (P< 0.05); ② 颈部转移灶热放组的完全缓解率比值比 3.89, 95% 可信区间 (2.26, 6.71) 和总有效率比值比 6.96, 95% 可信区间 (2.15, 22.48) 均显著好于单放组, 且其差异均有统计学意义 (P< 0.05); ③ 颈部转移灶热放化组的完全缓解率比值比 3.02, 95% 可信区间 (2.12, 4.29), 总有效率比值比 5.02, 95% 可信区间 (1.64, 15.33), 3 年总生存率比值比 2.81, 95% 可信区间 (1.82, 4.34), 5 年总生存率比值比 2.00, 95% 可信区间 (1.34, 2.99), 5 年无瘤生存率比值比 4.05, 95% 可信区间 (2.55, 6.43) 和 5 年局部控制率比值比 8.70, 95% 可信区间 (3.59, 21.12) 均显著好于放化组, 且其差异均有统计学意义 (P< 0.05). 结论 相较于单纯放疗或放化疗, 热疗综合疗法治疗鼻咽癌及其颈淋巴结转移能提高患者的近期疗效或远期生存率, 且安全性较好, 但其长期疗效和安全性评价尚需大样本高质量的随机对照研究进一步验证.

Abstract: Objective To evaluate the clinical efficacy and safety of hyperthermia combined with radiotherapy or radio-chemotherapy in treating primary nasopharyngeal cancer, and to provide references for clinical practice and research. Methods We searched foreign databases such as Cochrane Library, PubMed, EMBASE, Web of Science and Chinese ones including CBM, CNKI, VIP and WanFang with computer. In addition, we also retrieved other sources for supplying. All relevant randomized controlled trials (RCTs) were collected to compare hyperthermia combination therapy with radio-chemotherapy or radiotherapy alone. After literature screening, data extraction and quality evaluation were performed in accordance with the criteria of Cochrane handbook, the meta-analysis was conducted using RevMan 5.1 software. Results Twenty-one RCTs were selected with 1 680 patients included. Meta-analysis showed: ① The treatment group underwent radiotherapy plus intracavity hyperthermia for nasopharyngeal cancer. The complete response and total effective rate of treatment group were both higher than the control group with radiotherapy alone, the OR value and 95% CI were 3.13,(2.00, 4.92) and 6.84,(1.48, 31.60), respectively, and the differences between the two groups showed statistical significance (P< 0.05); ② The treatment group underwent hyperthermo-radiotherapy for cervical lymph node metastasis from nasopharyngeal cancer. The complete response and total effective rate of treatment group were both higher than the control group with radiotherapy alone, the OR value and 95% CI were 3.89,(2.26, 6.71) and 6.96,(2.15, 22.48), respectively, and the differences between the two groups showed statistical significance (P< 0.05); ③ The treatment group underwent hyperthermo-radio-chemotherapy for cervical lymph node metastasis from nasopharyngeal cancer. The complete response and total effective rate, 3-5-year survival rate, 5-year local control and progression free survival rate, these in the treatment group were all superior to radio-chemotherapy alone group, the OR value and 95% CI were 3.02,(2.12, 4.29), 5.02,(1.64, 15.33), 2.81,(1.82, 4.34), 2.00,(1.34, 2.99), 4.05,(2.55, 6.43), and 8.70,(3.59, 21.12), respectively, and …