Association of Glutathione S-transferase gene polymorphism with bladder Cancer susceptibility
原文： 2018 年 发布于
Eur Urol Focus
66 卷 第 1 期 1109-1120
浏览量：163次
作者：
Zhou T.
Li H. Y.
Xie W. J.
Zhong Z.
Zhong H.
Lin Z. J.
作者单位：
Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands. Department of Data Science and Knowledge Engineering, Maastricht University, Maastricht, Netherlands. Department of Clinical Studies and Nutritional Epidemiology, Nutrition Biomed Research Institute, Melbourne, Victoria, Australia. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Department of Epidemiology, School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, Netherlands. Department of Epidemiology, School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, Netherlands. Fred Hutchinson Cancer Research Center, Seattle, WA, USA. International Agency for Research on Cancer/WHO, Lyon, France. Department of Urology, Skåne University Hospital, Malmö, Sweden. Institution of Translational Medicine, Lund University, Malmö, Sweden. Department of Community Medicine, UIT The Arctic University of Norway, Tromsø, Norway. Danish Cancer Society Research Center, Copenhagen, Denmark. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia. Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia. CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands. School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom.
归属分类：
膀胱肿瘤治疗及预后证据
DOI：
10.1136/bmjopen-2020-043266
关键词：
膀胱肿瘤
二甲双胍
2型糖尿病
Meta分析
INTRODUCTION: Muscle-invasive bladder cancer (MIBC) is associated with high recurrence and mortality rates. The role of radiotherapy as an adjunct to radical cystectomy is not well-defined. We sought to evaluate the efficacy and safety of radiotherapy preoperatively or postoperatively for patients with MIBC receiving cystectomy compared to cystectomy alone. The primary outcome was overall survival. The secondary outcome was adverse effects. METHODS: MEDLINE, EMBASE, and CENTRAL were searched on August 30, 2016 for randomized controlled trials (RCTs) of patients undergoing cystectomy for bladder cancer. A control group receiving cystectomy alone and an intervention group with radiotherapy and cystectomy were required. The Jadad score was used to assess for bias. Fifteen studies representing 10 RCTs met eligibility criteria. RESULTS: A total of 996 patients were randomized in seven trials included in a meta-analysis of neoadjuvant radiotherapy. Insufficient data were available to complete a pooled analysis for adjuvant radiotherapy. There was a non-statistically significant improvement in overall survival for patients who received neo-adjuvant radiotherapy and cystectomy. At three years and five years, the odds ratios were 1.23 (95% confidence interval [CI] 0.72-2.09) and 1.26 (95% CI 0.76-2.09), respectively, in favour of neoadjuvant radiotherapy. Subgroup analyses including higher doses of radiotherapy showed greater effect on survival. CONCLUSIONS: These data suggest that radiotherapy prior to cystectomy may improve overall survival. This review was limited by old studies, heterogeneous patient populations, and radiotherapy treatment techniques that may not meet current standards. There is a need for current RCTs to further evaluate this effect.