短程放疗与长程放疗治疗转移性脊髓压迫的系统回顾与Meta分析

Short-term and long-term radiotherapy for metastatic spinal cord compression:a systematic review and Meta analysis

目的系统评价短程放疗(short-term radiotherapy,STRT)与长程放疗(long-term radiotherapy,LTRT)对转移性脊髓压迫(metastatic spinal cord compression,MSCC)患者运动功能、6个月局部控制率和6个月生存率的影响。方法对万方、知网、维普、Pubmed、Highwire、Springer、EBSCO等数据库进行检索,选择MSCC患者行STRT和LTRT治疗预后的对照研究文献,进行文献质量评价后,采用Revman 5.3软件进行数据分析。结果共纳入6篇文献,Meta分析结果显示,STRT和LTRT放疗后运动功能改善率(RR=0.99,95%CI=0.46~1.77,P>0.05)、运动功能稳定率(RR=0.94,95%CI=0.78~1.13,P>0.05)、运动功能进展率(RR=0.58,95%CI=0.16~2.09,P>0.05)、6个月局部控制率(RR=0.94,95%CI=0.83~1.05,P>0.05)和6个月生存率(RR=1.36,95%CI=0.83~2.25,P>0.05)均无明显差异。结论STRT和LTRT两种放疗方案对MSCC患者短期生存率、局部控制和运动功能方面的影响,均未见显著性差异。

Objective To systematically evaluate the effects of short-term radiotherapy(STRT)and long-term radiotherapy(LTRT)on motor function,6-month local control rate and 6-month survival rate of metastatic spinal cord compression(MSCC).Methods Wanfang,CNKI,VIP,PubMed,HighWire,Springer,EBSCO and other databases were searched.The controlled studies of STRT and LTRT on the prognosis of MSCC were selected.After literature quality evaluation,Revman 5.3 was used for data analysis.Results Six articles were included,and Meta analysis showed that there were no significant differences in improvement rate of motor function(RR=0.99,95%CI=0.46-1.77,P>0.05),stability rate of motor function(RR=0.94,95%CI=0.78-1.13,P>0.05),progression rate of motor function(RR=0.58,95%CI=0.16-2.09,P>0.05),local control rate of 6 months(RR=0.94,95%CI=0.83-1.05,P>0.05)and 6-month survival rate(RR=1.36,95%CI=0.83-2.25,P>0.05)between the STRT group and LTRT group(P>0.05).Conclusion There are no significant differences in short-term survival rate,local control and motor function between STRT and LTRT.