非小细胞肺癌立体定向放疗后副反应的Meta分析

Side effects following stereotactic radiotherapy in non-small cell lung cancer:A meta-analysis

目的：系统评价体部立体定向放疗治疗非小细胞肺癌后常见毒副反应放射性肺炎、胸壁疼痛、肋骨骨折的发生率。方法电子检索 Medline、Pubmed、EBSCO等外文数据库及中国知网、中国生物医学文献数据库、万方等中文数据库，检索时间均截至于2014年2月，阅读并筛选描述立体定向放射治疗后常见毒副反应发生的相关文献。通过 R软件 Meta软件包中的 Metaprop函数进行统计学分析，记录立体定向放疗（SBRT）后放疗毒副反应的发生率。结果共纳入27篇文献，其中15篇为前瞻性研究，回顾性分析12篇，均为英文文献。常见毒副反应包括放射性肺炎、胸壁疼痛、肋骨骨折等，其发生率分别为18．24％[95％CI （13．24％～24．59％）]、18．67％[95％CI （13．77％～24．11％）]、12．45％[95％CI （7．28％～20．47％）]。结论立体定向放射治疗后常见的毒副反应主要是放射性肺炎、胸壁疼痛、肋骨骨折，影响患者的预后及生活质量，制定计划的过程中应根据副反应发生的高危因素尽量降低其发生率，提高患者的生活质量。

Objective To systematically review the common side effects incidence rate of stereotactic body radiotherapy treatment in non-small cell lung cancer patients.Methods Data was from electronic databases at home and abroad such as：Medline,Pubmed,EBSCO;Chinese Journal Fulltext Database （CNKI）, Chinese Biomedical Literature Database （CBM）and Wan Fang DATA ,and the retrieval time was Febru-ary 2014.Then related literature data described the common side effects after the stereotactic radiotherapy was screened.A proportion meta analysis across the studies was performed for the side effects incidence af-ter stereotactic radiotherapy with the use of R software.Results Twelve retrospective studies and fifteen prospective studies were included,the common side effects concluded radiation pneumonitis,chest wall pain and rib fractures.Their incidences were respectively 18.24%[95%CI （13.24%~24.59%）],18.67%[95%CI （13.77%~24.11%）],12.45%[95%CI （7.28%~20.47%）].Conclusion Common side effects after stereotactic radiotherapy are mainly of radiation pneumonitis,chest wall pain,rib fractures,which should be taken into consideration to reduce the incidence and improve the prognosis of patients while plan-ning the medical plan.