碳离子放疗治疗骨肉瘤的疗效和安全性：系统评价和荟萃分析。
Efficacy and safety of carbon ion radiotherapy for bone sarcomas: a systematic review and meta-analysis.
机构信息
Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, People's Republic of China.
The First School of Clinical Medicine, Lanzhou University, No.1, Donggang West Road, Lanzhou, 730000, People's Republic of China.
出版信息
Radiat Oncol. 2022 Oct 25;17(1):172. doi: 10.1186/s13014-022-02089-0.
OBJECTIVE
This study aimed to systematically evaluate and conduct a meta-analysis of the efficacy and safety of carbon ion radiotherapy for bone sarcomas.
METHODS
We searched for articles using the PubMed, Embase, Cochrane Library, and the Web of Science databases from their inception to January 12, 2022. Two researchers independently screened the literature and extracted data based on the inclusion and exclusion criteria. Statistical analyses were performed using STATA version 14.0.
RESULTS
We searched for 4378 candidate articles, of which 12 studies were included in our study according to the inclusion and exclusion criteria. Of the 897 BSs patients who received carbon ion radiotherapy in the studies, 526 patients had chordoma, 255 patients had chondrosarcoma, 112 patients had osteosarcoma, and 4 patients had other sarcomas. The local control rate at 1, 2, 3, 4, 5, and 10 years in these studies were 98.5% (95% confidence interval [CI] = 0.961-1.009, I = 0%), 85.8% (95% CI = 0.687-1.030, I = 91%), 86% (95% CI = 0.763-0.957, I = 85.3%), 91.1% (95% CI = 0.849-0.974), 74.3% (95% CI = 0.666-0.820, I = 85.2%), and 64.7% (95% CI = 0.451-0.843, I = 95.3%), respectively. The overall survival rate at 1, 2, 3, 4, 5, and 10 years in these studies were 99.9% (95% CI = 0.995-1.004, I = 0%), 89.6% (95% CI = 0.811-0.980, I = 96.6%), 85% (95% CI = 0.750-0.950, I = 89.4%), 92.4% (95% CI = 0.866-0.982), 72.7% (95% CI = 0.609-0.844, I = 95.3%), and 72.1% (95% CI = 0.661-0.781, I = 46.5%), respectively. Across all studies, the incidence of acute and late toxicities was mainly grade 1 to grade 2, and grade 1 to grade 3, respectively.
CONCLUSION
As an advanced radiotherapy, carbon ion radiotherapy is promising for patients with bone sarcomas that are unresectable or residual after incomplete surgery. The data indicated that carbon ion radiotherapy was safe and effective for bone sarcomas, showing promising results for local control, overall survival, and lower acute and late toxicity.
PROSPERO REGISTRATION NUMBER
CRD42021258480.
目的
本研究旨在系统评价和进行荟萃分析碳离子放疗治疗骨肉瘤的疗效和安全性。
方法
我们使用 PubMed、Embase、Cochrane 图书馆和 Web of Science 数据库从其建立到 2022 年 1 月 12 日进行了文献检索。两位研究人员根据纳入和排除标准独立筛选文献并提取数据。使用 STATA 版本 14.0 进行统计分析。
结果
我们搜索了 4378 篇候选文章，根据纳入和排除标准，有 12 项研究符合我们的研究标准。在这些研究中，897 例 BSs 患者接受了碳离子放疗，其中 526 例患者患有脊索瘤，255 例患者患有软骨肉瘤，112 例患者患有骨肉瘤，4 例患者患有其他肉瘤。这些研究中，1、2、3、4、5 和 10 年的局部控制率分别为 98.5%（95%置信区间 [CI] = 0.961-1.009，I = 0%）、85.8%（95% CI = 0.687-1.030，I = 91%）、86%（95% CI = 0.763-0.957，I = 85.3%）、91.1%（95% CI = 0.849-0.974）、74.3%（95% CI = 0.666-0.820，I = 85.2%）和 64.7%（95% CI = 0.451-0.843，I = 95.3%）。这些研究中，1、2、3、4、5 和 10 年的总体生存率分别为 99.9%（95% CI = 0.995-1.004，I = 0%）、89.6%（95% CI = 0.811-0.980，I = 96.6%）、85%（95% CI = 0.750-0.950，I = 89.4%）、92.4%（95% CI = 0.866-0.982）、72.7%（95% CI = 0.609-0.844，I = 95.3%）和 72.1%（95% CI = 0.661-0.781，I = 46.5%）。在所有研究中，急性和迟发性毒性的发生率主要为 1 级至 2 级和 1 级至 3 级。
结论
作为一种先进的放疗方法，碳离子放疗对无法切除或手术后残留的骨肉瘤患者具有应用前景。数据表明，碳离子放疗对骨肉瘤安全有效，局部控制、总体生存率以及急性和迟发性毒性均有较好的结果。
PROSPERO 注册号：CRD42021258480。
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