作　　者： (张立进）; (吴斌）; (于波）; (沙莎）; (王彩萍）; (袁军）; (查振雷）; (赵虎）;

机构地区： 东南大学医学院附属江阴医院泌尿外科,江阴214400

出　　处： 《中华放射肿瘤学杂志》 2017年第9期1050-1054,共5页

摘　　要： 目的 Meta分析三维放疗对前列腺癌疗效。方法 在2名独立研究员制定相关文献的检索策略以及纳入、剔除标准后,通过检索PubMed、荷兰医学文献数据库、中国知网、万方数据库中有关三维放疗前列腺癌有关研究。检索时间为开始建库至2017年2月,限定语种为英文与中文。采用RevMan 5.3软件对相关文献资料进行数据处理与分析。结果 根据严格的检索策略及纳入、排除标准共纳入15篇相关临床研究,均为回顾性队列研究。相关患者4608例,其中IMRT组2229例,3DCRT组2379例。IMRT与3DCRT组在泌尿系早晚期损伤上相近（OR=0.77,95%CI为0.43~1.40,P=0.390;OR=0.75,95%CI为0.55~1.04,P=0.080）;肠道早、晚期损伤IMRT比3DCRT组少（OR=0.47,95%CI为0.27~0.82,P=0.008;OR=0.52,95%CI为0.35~0.78,P=0.001）;无生化复发生存率IMRT比3DCRT组高（OR=1.87,95%CI：1.51~2.32,P=0.000）。结论 IMRT相比3DCRT在治疗前列腺癌过程中对肠道损伤的保护作用最为明显,同时无生化复发生存率也相对较高。 Objective To systcmatically compare the efficacy of three-dimensional conformal radiotherapy （3D-CRT） versus intensity-modulated radiotherapy （IMRT） in the treatment of prostate cancer （PCa）. Methods Clinical comparative studies of IMRT and 3D-CRT in the treatment of PCa were collected from PubMed, EMBASE, China National Knowledge Infrastructure （CNKI）, and Wanfang Data after two independent researchers developed the strategy and inclusion and exclusion criteria for the literature search. Articles published up to February 2017 were searched for, and the languages of publications were restricted to English and Chinese. Clinical meta-analysis of the data from the relevant studies was performed using the RevMan5.3 software. Results A total of 15 relevant retrospective cohort studies were collected from the databases in strict accordance to the search strategy and inclusion and excluding criteria. There were 4608 PCa patients, including 2229 in the IMRT group and 2379 in the 3D-CRT group. IMRT and 3D-CRT had similar adverse effects in terms of early-stage （odds ratio[OR]=0.77, 95% confidence interval[CI]：0.43-1.40, P=0.390） and late-stage （OR=0.75, 95%CI：0.55-1.04, P=0.080） urinary tract injury. However, IMRT led to reduced early-stage （OR=0.47, 95%CI：0.27-0.82, P=0.008） and late-stage （OR=0.52, 95%CI：0.35-0.78, P=0.001） intestinal injury compared with 3D-CRT. Meanwhile, the biochemical recurrence-free survival rate was also significantly higher in the IMRT group than in the 3D-CRT group （OR=1.87, 95%CI：1.51-2.32, P=0.000）. Conclusions IMRT is more protective against intestinal injury with a higher biochemical recurrence-free survival rate compared with 3D-CRT during the treatment of PCa.

关 键 词： 前列腺肿瘤 调强放射疗法 前列腺肿瘤 三维适形放射疗法 分析