冷冻消融对高危与局部复发前列腺癌疗效的荟萃分析

Effect on cryoablation of high-risk and locally recurrent prostate cancer： a Meta.analysis

目的采用荟萃分析方法系统评价冷冻消融术对高危与局部复发前列腺癌的治疗效果及预后。方法在PubMed等数据库检索自建库至2016年3月关于高危与局部复发前列腺癌冷冻消融治疗及放疗文献，筛选文献并提取所纳入文献患者的5年无生化复发率等相关信息。选取Stataver,11软件运用随机效应模型合并5年无生化复发率（bDFS）及其95％可信区间。结果补救冷冻5年bDFS45％（95％CI0．43-0．47），补救放疗5年bDFS45％（95％CI0．44-0．47）。高危冷冻5年bDFS66％（95％CI0．64-0．67），高危放疗和高危单EBRT5年bDFS分别为61％（95％CI0．60-0．63）和54％（95％CI0．52～0．56）。结论接受补救性治疗的局部复发前列腺癌患者，冷冻消融与放疗5年bDFS接近。对于高危前列腺癌，冷冻消融治疗对比传统单纯EBRT放疗显示出明显的优势。

Objective To discuss the curative effect and prognosis of cryoablation to high-risk and locally recurrent prostate cancer patients. Methods Cryoablation related publications and relevant references were searched for potential pertinent articles until March ,2016. Articles were selected according to the exclusion criteria, Stata vet. 11 was used to perform the statistical analysis. Results 5-year biochemical disease-free survival of salvage ablation for prostate cancer was 45% （95% CI 0. 43 -0. 47 ） , in salvage radiotherapy of 45% （95% CI 0. 44 - 0. 47 ）. The 5-year biochemical disease-free survival of high-risk prostate cancer cryoablation was 66% （ 95% CI0. 64 - 0. 67 ）. The result of high-risk prostate cancer radiotherapy and EBRT were respectively 61% （95% CI 0. 60 -0. 63 ） and 54% （95% CI0. 52 -0. 56 ）. Conclusions The five-year biochemical recurrence of salvage cryoablation is similar to salvage radiotherapy. For high-risk prostate cancer, cryoablation shows an advantage than traditional EBRT radiation.