头颈部肿瘤螺旋断层放疗与动态调强放疗剂量学比较——Meta分析

Dosimetric comparison of helical tomotherapy and intensity modulated radiotherapy in head-and-neck cancer:A Meta-analysis

目的:探讨螺旋断层放疗的优势及不足,为临床治疗提供有价值的循证医学依据。方法:计算机检索Pub Med、EMBASE、Science、中国知网和万方等数据库,筛选头颈部肿瘤螺旋断层放疗与动态调强放疗剂量学比较的文章,应用Stata SE 12.0软件对满足条件的数据进行Meta分析。结果:纳入10篇文章。螺旋断层放疗较动态调强放疗靶区的均匀性明显提高(SMD=-1.529,95%CI:-2.265^-0.793,P<0.001),脊髓D_(max)及脑干D_(mean)等比较,差异均有统计学意义。而脑干D_(max)、视交叉D_(max)及喉D_(mean)等比较,差异无统计学意义。结论:头颈部肿瘤螺旋断层放疗比动态调强放疗靶区分布更均匀,可明显降低高剂量区的照射靶体积,对危及器官如脊髓、脑干的保护更优。

Objective: To evaluate the advantage and disadvantage of helical tomotherapy( HT) by Meta- analysis. Methods: Clinical researches of dosimetric comparison between HT and intensity modulated radiotherapy( IMRT)for head- and- neck cancers were obtained from the Pubmed,Science,Embase,CNKI( Zhongguozhiwang) and Wanfang databases up to Octobor 2015. The data calculated and analyzed using the Stata SE 12. 0 software. Results: Ten researches were included. Comparing to IMRT,HT significantly increased the homogeneity of dose distribution( SMD=- 1. 529,95% CI:- 2. 265 ^- 0. 793,P < 0. 001). IMRT significantly lowered the spinal cord D_(max) and brainstem D_(mean),brainstem D_(max),optic chiasma D_(max) and larynx D_(mean) were not lowered. Conclusion: Comparing to IMRT,HT achieves better homogeneity of dose distribution and reduces irradiated volumes of spinal cord and brainstem.