| Objective:The purpose of this study was to evaluate the effect of combining radiotherapy and chemotherapy with preserving bladder surgery by comparing the efficacy of preserving bladder surgery with chemoradiation and radical cystectomy in the treatment of muscle-invasive bladder cancer.Provide more evidence for clinical treatment decisions.Methods:A search strategy was developed to comprehensively search Pub Med,OVID LWW,Web of Science,VIP,CNKI,CMCI and Wanfang Database.The search time for each database was January 01,1997 to December 2017.31st.According to the relevant inclusion and exclusion criteria,the literature was selected,and the information was extracted based on the information extraction table.Meta analysis was performed using Rev-Man5.3 software provided by Cochrane Collaboration.Results:A total of 9 studies were included in a total of 1201 patients.Among them,561 patients underwent combined chemoradiotherapy and postoperative radiotherapy and chemotherapy in the experimental group and640 patients underwent radical cystectomy in the control group.Meta-analysis showed that the heterogeneity test of all the literatures showed that I~2<50%,and the heterogeneity was low.Therefore,a fixed effect model was used.The upper and lower limits of the 95%confidence interval for all study groups included 1,P>0.05,which was considered statistically insignificant;the overall results for the 9 groups were the test statistics Z=0.44 for two treatment plans,combined OR=1.06,The 95%confidence interval was 0.82to 1.38,P=0.64,P>0.05.There was no significant difference in the 5-year survival rate of the two treatment options.Conclusions:Patients with muscle-invasive bladder cancer who meet the appropriate indications choose preserving bladder combined with radiotherapy and chemotherapy.It does not reduce the long-term prognosis of patients and retains the function of the bladder.The postoperative quality of life of patients is better than patients who choose radical surgery. |
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