Luo Meng-Si, Huang Guan-Jiang, Liu Hong-Bing
Department of Anesthesiology, Zhongshan Hospital of Traditional Chinese Medicine, Affiliated to Guangzhou University of Chinese Medicine, Zhongshan, Guangdong Province.
Department of Otorhinolaryngology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province.
Medicine (Baltimore). 2019 Jun;98(24):e15951. doi: 10.1097/MD.0000000000015951.
Nasopharyngeal carcinoma (NPC) is a prevalent malignancy in Asia particularly southern China. Comparisons of outcomes of conformal radiotherapy (CRT) and intensity-modulated radiotherapy (IMRT) have been still debated. This meta-analysis was carried out to compare oncologic outcomes of CRT and IMRT in the treatment of NPC.
A literature search was performed through PubMed, Embase, and the Cochrane library databases from their inceptions to November 10, 2018. Two authors assessed the included studies and extracted data independently. Relative studies that compared oncologic outcomes between CRT and IMRT for NPC were included.
A total of 13 eligible studies were included, which contained 1 RCT, 1 prospective study, and 11 retrospective studies. Our meta-analysis showed that IMRT has increased overall survival (OR = 0.51, 95% CI = 0.41-0.65, P < .00001), locoregional control rate (OR = 0.59, 95% CI = 0.52-0.67, P < .00001), disease-free survival (OR = 0.77, 95% CI = 0.65-0.91, P = .002), and metastasis-free survival (OR = 0.71, 95% CI = 0.54-0.94, P = .01) in comparison with CRT.
The results of this meta-analysis indicate IMRT should be a better option for the treatment of NPC because patients who underwent IMRT may benefit from increased overall survival, locoregional control rate, disease-free survival, and metastasis-free survival compared with CRT.
鼻咽癌(NPC)是亚洲尤其是中国南方常见的恶性肿瘤。适形放疗(CRT)和调强放疗(IMRT)的疗效比较仍存在争议。本荟萃分析旨在比较CRT和IMRT治疗NPC的肿瘤学疗效。
通过PubMed、Embase和Cochrane图书馆数据库进行文献检索,检索时间从建库至2018年11月10日。两位作者独立评估纳入研究并提取数据。纳入比较CRT和IMRT治疗NPC肿瘤学疗效的相关研究。
共纳入13项符合条件的研究,其中包括1项随机对照试验、1项前瞻性研究和11项回顾性研究。我们的荟萃分析表明,与CRT相比,IMRT提高了总生存率(OR = 0.51,95%CI = 0.41 - 0.65,P <.00001)、局部区域控制率(OR = 0.59,95%CI = 0.52 - 0.67,P <.00001)、无病生存率(OR = 0.77,95%CI = 0.65 - 0.91,P =.002)和无转移生存率(OR = 0.71,95%CI = 0.54 - 0.94,P =.01)。
本荟萃分析结果表明,IMRT应是治疗NPC的更好选择,因为与CRT相比,接受IMRT治疗的患者可能从提高的总生存率、局部区域控制率、无病生存率和无转移生存率中获益。