| Objective：To evaluate effect of neoadjuvant chemotherapy for the postoperative long-termsurvival rate of NSCLC by meta-analysis.Methods：A systematic search of2Chinese electronic databases (Wanfang,VIP),and3English database (Pubmed, Cochrane Library) up to June2013was performed for theRandomized clinical trials(RCTs) of the neoadjuvant chemotherapy for NSCLC afterchoosing data.We also made the subgroup meta-analysis.Subsequently,we made theheterogeneity analysis and sensitivity analysis to avoid the bias.All above analyseswere performed by Revman4.2. We evaluated the reliability of the meta-analysis bythe Nfs after the P-value and Z-value were obtained by SPASS17.0.Results：17RCTs were enrolled in the meta-analysis,the neoadjuvant chemoherapy plussurgery group(study group):1879,surgery group(control group):1898.There was statistical significant difference between the study group and surgery controlgroup,Fixed effect model:OR=0.75（95%CI0.66-0.87）, P＜0.0001. Random effectmodel:OR=0.75（95%CI0.62-0.91）. The same effect was also observed in stage ⅢNSCLC, OR(odds radio)=0.59（95%CI0.48-0.72）, P＜0.00001. When analysis wasperformed in the studies of Jadad=3, the statistical significant differencestill exist,OR=0.79(95%CI0.67-0.93,P=0.006). After deleted studies(Zhou,Yao),OR=0.82(95%CI0.70-0.97).After deleted the study(Depierre),Fixed effect model：OR=0.76(95%CI0.66-0.88). Random effect model:OR=0.75(95%CI0.61-0.93）.Allabove showed the results were advantageous to the chemotherapy group,and therewere statistical significant difference between the two groups.The funnel plot methodand Nfs showed no significant bias in the meta-analysis.Conclusions：Our meta-analysis shows a benefit of neoadjuvant chemotherapy to the patientswith resectable NSCLC in postoperative long-term survival rate. Stage Ⅲ benefitedfrom neoadjuvant chemotherapy more than Stage I/II.However,Further studies wereneeded based on the limitation of the study. |
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