质子束疗法与多重恶性瘤的光子疗法:一个总体系统性审查和元分析
Zhenyu Ma1, Qipeng Yuan2, Mei Liu1
1Shandong University Cancer Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
与光子疗法相比,质子束疗法 (PBT) 显示出改善癌症结果和降低毒性. 然而,高质量的证据是有限的,需要进一步的大规模临床试验进行验证.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 在恶性疾病中,质子束疗法 (PBT) 和光子疗法之间的比较证据很少.
- 现有的研究往往缺乏直接比较,阻碍了最终的治疗选择.
研究的目的:
- 系统地审查和综合现有比较PBT和光子疗法用于各种癌症的元分析.
- 评估PBT与光子疗法的比较疗效和毒性概况.
主要方法:
- 在2025年3月之前,对PBT与光子疗法的元分析进行电子数据库的全面搜索.
- 使用AMSTAR 2进行元分析的方法质量评估.
- 使用德西米尼安和莱尔德随机效应模型复制元分析和使用GRADE标准评估证据确定性.
主要成果:
- 包括包括11种癌症类型的17个元分析.
- 与光子疗法相比,PBT在质瘤,头癌,食道癌等方面的预后有所改善.
- 在头癌,儿科中枢神经系统瘤,食道癌和其他疾病中,PBT使用与减少毒性影响相关,尽管证据确定性通常低至非常低.
结论:
- 在几种瘤类型中,PBT与改善生存率和降低毒性有关.
- 目前的证据基础在很大程度上是低确定性,强调需要高质量的,大规模的比较研究和临床试验来验证这些发现.
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