中国大陆地区鼻咽癌放疗后放射性脑病的系统评价

Radiation encephalopathy in nasopharyngeal carcinoma patients in China's Mainland: a systematic evaluation

目的 了解中国大陆地区鼻咽癌放射治疗后放射性脑病的整体情况。方法 应用系统评价的方法 ,经过计算机检索、确定文献的入选与排除标准以及资料摘录等过程 ,对描述该病临床特征和与发病相关因素的数据进行统计学处理。结果 共有 16家医院、18篇文献、累计病例数为 5 5 3例的资料进入研究。在CT或MRI检查的条件下 ,放射性脑损伤的发生率平均为 1.9% ;病变部位位于颞叶和脑干 ;首程常规放疗后脑病患者鼻咽和颅底区放疗总剂量的均数为 72 .9Gy;发病的潜伏期平均为 3.6年。结论 为了准确地掌握鼻咽癌放射性脑病的临床特征 。

Objective To evaluate the clinical characteristics of radiation encephalopathy in nasopharyngeal carcinoma (NPC) patients of China's Mainland. Methods Based on the principle of systematic review, the search for literature in computerized Chinese Biology & Medicine database, 1979 to June 2001 (CBM) was performed, with the papers appraised according to conformation criteria, the methodological quality of the studies analyzed, and clinical data of patients processed using the statistical model. Results 553 cases accumulated from 18 identified articles submitted by 16 hospitals in China were analyzed. The mean incidence of encephalopathy diagnosed by CT or MRI was 1.9 % (0.4% 2.6%). The disease focus was located in the temporal lobe (80 %) and in the brain stem (17 %). The mean dose received in the first course of radiotherapy to the nasopharynx or skull base was 72.9 Gy, and the latent period of this disease was 3.6 years. Conclusion The probability of encephalopathy after radiation for nasopharyngeal carcinoma in China's Mainland is reported in this review. Multi center case control or Cohort studies are required in the future.