ABSTRACT
BACKGROUND@#To compare the clinical efficacy of stereotactic body radiotherapy (SBRT) versus surgery for early-stage non-small cell lung cancer through evidence based medicine analysis.@*METHODS@#A systematic search was performed in the PubMed, EMBASE, CNKI and Wan Fang databases to find studies published before June 2020. Two authors independently extracted the data and assessed the eligibility. All of the statistical analyses were performed using Stata 13.0. Subgroup analysis were performed according to the score matching study and operation type (lobectomy, segmentectomy and thoracoscopic assisted surgery).@*RESULTS@#Finally, 14 articles were included, including 15,841 cases in SBRT group and 17,708 cases in operation group. 10 articles used propensity score matching methods for survival analysis. Thirteen were retrospective cohort studies and one was randomized controlled trial. The results of meta-analysis showed that the overall survival rate of the surgery group and the SBRT group was statistically significant. The overall survival rate of the SBRT group (HR=1.51, 95%CI: 1.31-1.74) was inferior to that of the surgery group. In the subgroup analysis of the surgical type, there was no statistical difference between the SBRT group and each surgical type. The difference of overall survival rate between SBRT group and surgery group was statistically significant (HR=1.66, 95%CI: 1.45-1.90) in studies of propensity score matching. There was no statistically significant difference in cancer-specific survival between the surgery and SBRT groups (HR=1.12, 95%CI: 0.83-1.52).@*CONCLUSIONS@#The overall survival rate of surgical treatment is better than that of SBRT, but it has no obvious advantages in cancer specific survival rate.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Reduning injection for treating community-acquired pneumonia.</p><p><b>METHOD</b>Literatures about randomized controlled trials of Reduning injection for treating community-acquired pneumonia were reviewed. The methodological quality of the trials was assessed by the Jadad scale, and evaluation was performed.</p><p><b>RESULT</b>Seven RCTS were included. Reduning combined group (Reduning injection plus antibiotics and basic therapy) was compared with antibiotics group (antibiotics plus basic therapy). Meta-analysis showed that the relative risk (RR) for the total cure rate was 1.34, and 95% confidence interval (CI) was [1.19, 1.51]; RR for the total effective rate was 1.10, and 95% CI was [1.06, 1.15]. The weighted mean difference (WMD) in disappearance time of fever between the two groups was - 1.42, and 95% CI was [- 2.58, -0.26]; The WMD between the two groups for the total obvious effect rate of cough and expectoration were - 2.36, and 95% CI was [- 3.41, - 1.31]; Improve the time of pulmonary rales MD -2.30, 95% CI [- 2.61, - 2.00]; The WMD between the two groups in absorption of chest x-ray shadow was -2.36 and 95% CI [-2.52, -2.20]. Serious systematic adverse reactions had not been reported in the trials.</p><p><b>CONCLUSION</b>The effect of combined therapy with Reduning injection plus antibiotics and basic therapy is better than that of antibiotics plus basic therapy. Reduning injection can improve the symptoms of cough and expectoration, shorten the fever time and facilitate the absorption of chest x-ray shadow without any significant adverse reactions. However, further high quality trials are needed.</p>