近距离放射疗法与前列腺根治切除治疗局限性前列腺癌的疗效比较——meta分析

Comparison of the therapeutic effect of localized prostate carcinoma treated with radical prostatectomy and brachytherapy

目的比较前列腺粒子植入近距离放射疗法与根治性前列腺切除术治疗局限性前列腺癌的疗效。方法收集国内外1979年1月至2007年7月已公开发表的有关局限性前列腺癌行根治性前列腺切除术和粒子植入近距离放射治疗疗效比较的临床对照试验文献,对符合要求的研究进行同质性检验,采用四格表数据的Meta分析方法(Peto法)计算比值比(OR)和95%可信区间(CI)。结果符合要求入选的研究文献共有4项,共2305例病例,其中根治性前列腺切除1244例,前列腺粒子植入1061例;两种治疗方法术后5年无瘤存活率合并比值比(OR)是[OR0.68,95%CI(0.44,1.05)],差异无统计学意义。结论根据现有研究资料可知两种治疗方式对于局限性前列腺癌术后5年生存率没有明显差别,两种方法均可作为局限性前列腺癌有效和可靠的治疗手段。

Objective To compare the therapeutic effect of treating localized prostate carcinoma by radical prostatectomy and brachytherapy. Methods Experiment results of brachytherapy and radical prostatectomy to treat localized prostate carcinoma from January 1979 to July 2007 were collected. Meta analysis was used for homogeneity test in studies meeting the criteria. The fourfold Meta analysis （Peto） was used to calculate the odds ratio （OR） and 95% confidence interval （IC）. Results Four trials were chosen in the research, in which 1 244 cases were treated using radical prostatectomy and 1 061 using brachytherapy. There was no significant difference 5 years after these two therapy methods. The OR was 0.68, 95% CI （0.44, 1. 05）. Conclusion According to current research results, there is no significant difference between radical prostatectomy and brachytherapy in 5-year recurrence-free survival in treating localized prostate carcinoma. These two therapies are effective and safe.