连续加速超分割放疗和后程加速超分割放疗治疗食管癌的Meta分析

The effect of continuous accelerated hyperfractionated and late-course accelerated hyperfractionated radiotherapy on esophageal cancer: a Meta-analysis

目的评价连续加速超分割(CAHF)和后程加速超分割(LCAF)放射治疗食管癌的疗效及安全性。方法计算机检索Pub Med、EMBASE、Web of Science、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库及万方数据库,并辅以手工检索。收集CAHF和LCAF放射治疗食管癌临床对照试验,按照Cochrane系统评价手册5.2.质量评价标准,对纳入文献方法学进行质量评价,用Rev Man5.2软件进行Meta分析。结果共纳入5篇文献,共530例患者,其中LCAF组273例,CAHF组257例患者,经Meta分析结果显示,与CAHF组相比,LCAF组降低了放射性食管炎〔OR=4.35,95%CI(1.45,13.04),P=0.009〕、放射性气管炎〔OR=1.64,95%CI(1.07,2.51),P=0.02〕的发生,但对于生存率〔OR=0.89,95%CI(0.71,1.11),P=0.30〕及局部控制率〔OR=1.00,95%CI(0.76,1.30),P=0.98〕两组无明显差异。结论后程加速超分割放射治疗较全程加速超分割治疗食管癌降低不良反应,但生存率及局部控制率两组无明显差别。

Objective To evaluate the efficacy and safety of continuous accelerated hyperfractionated（ CAHF） and late-course accelerated hyperfractionated radiotherapy（ LCAF） in the treatment of esophageal carcinoma. Methods Pub Med,EMBASE,Web of Science,China National knowledge internet,China Biology Medicine,Wan Fang Data were searched,the related field and other magazines were retrieved manually to identify all clinical controlled trials on CAHF versus LCAF in the treatment of esophageal carcinoma. Quality assessment and date extraction were done according to the Cochrane Reviewer＇s handbook 5. 2. Meta-analysis was performed by Rev Man5. 2 software.Results There were 5 studies included,total 530 patients,257 in CAHF group,273 in LCAF group. The meta-analysis showed that LCAF reduced the incidence rate of acute radiation trachitis〔OR = 1. 64,95% CI（ 1. 07,2. 51）,P = 0. 02〕and acute radiation oesophagitis〔OR =4. 35,95% CI（ 1. 45,13. 04）,P = 0. 009〕versus CAHF. But there were no significant benefit for LCAF and CAHF in survival〔OR = 0. 89,95% CI（ 0. 71,1. 11）,P = 0. 30 〕and local control rates 〔OR = 1. 00,95% CI（ 0. 76,1. 30）,P = 0. 98 〕. Conclusions The toxicities of CAHF are heavier than LCAF,but the survival rate and local control rate have no significant differences.