| The morbidity and mortality of Lung Cancer ranks first in malignanttumor.Non-small cell lung cancer (NSCLC) accounts for80%to85%of LungCancer.Most of them have lost radical operation opportunity as poor stage whenfound.They used to be treated with palliative chemotherapy and supportive care.Thepatients had poor quality of life and short survival time.Majority of them died in oneyear.ECOG1594study shows that third generation chemotherapy including gemcitabinecombined with platinum have equal effect.And domestic research also shows thatplatinum containing two drugs chemotherapy has equal effect and effective rate is30%-50%.It has become standard first-line chemotherapy.Whole-body hyperthermia isanother important method for tumor besides operation,chemotherapy,radiotherapy andbiological therapy.It’s reported that whole-body hyperthermia can kill tumor cellsselectively and control them from wide metastasis by thermal effect when body temperature increased to41.8-42.0.In recent years, there are a large number of studiesabout whole-body hyperthermia treating malignant tumors.And they reached obviouscurative effect in advanced malignant tumor or refractory cancer.Then,how about theefficacy and safety of whole-body hyperthermia combined with chemotherapy in view oflung cancer?We designed this clinical research to compare them in stage ⅢB/ⅣNSCLC.Then we meta-analysed the clinical researches to provide high quality evidencefor clinical decision.164cases of pathologically diagnosed stage ⅢB/Ⅳ NSCLC patients were randomlyassigned to whole-body hyperthermia combined with chemotherapy (WBH) group andchemotherapy (CT) group in ratio of1:4.The two groups are comparable (p>0.05) in termsof age,gender,pathological type,clinical stage and chemotherapy drugs.Theprogression-free survival time(PFS) of WBH group was5.2months,which wassignificantly higher than that of CT group (3.5months) and had significant statisticaldifference (p=0.003).Subgroup analysis showed that the progreeesion-free survival time ofWBH group was significantly higher than that of CT group and had statistical difference(P<0.05) no matter genger,pathological type and chinical stage.Survival analysis alsoshowed its advantages.The disease control rate of WBH group was82.8%,a little higherthan that of CT group (78.3%),and hadn’t statistical difference(P=0.557).There was nostatistical difference between two groups in treatment related adverse reaction.The resultsshowed that whole-body hyperthermia combined with chemotherapy is safe and valid forstage ⅢB/Ⅳ NSCLC and is expected to become an assistant method to treat advancedNSCLC.Furtherly clinical studies of whole-body hyperthermia combined with chemotherapytreating local advanced or advanced NSCLC were meta analysed and effective rate wasused to compre the effect.The results showed that WBH group had higher effective ratethan CT group and average effective rate was66.19%and24.68%each.There was nosignificant heterogeneity between documents (P=0.99) and no significant publication biasin the included literature.There was no statistical difference in toxicity including Ⅲ/Ⅳdegree liver and kidney dysfunction,myelosuppression and gastrointestinial tract reaction in two groups.The results showed that the effect of whole-body hyperthermia combinedwith chemotherapy was superior to that of chemotherapy alone to treat local advanced oradvanced NSCLC.In summary,we explored the effect and safety of whole-body hyperthermia combinedwith chemotherapy to treat stage ⅢB/Ⅳ NSCLC.We drew a conclusion that the effect ofwhole-body hyperthermia combined with chemotherapy was superior to that ofchemotherapy and the toxicity was tolerated.So it’s expected to become an assistant wayto treat advanced NSCLC.And we meta analysed clinical researches of whole-bodyhyperthermia combined with chemotherapy to treat local advanced or advanced NSCLCfirstly and furtherly clarified that the effect of whole-body hyperthermia combined withchemotherapy is better than that of chemotherapy alone,which provided high levels ofevidence for evidence-based medicine. |
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