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雄激素剥夺疗法联合放疗治疗中危前列腺癌:系统评价和荟萃分析。

Androgen deprivation therapy and radiotherapy in intermediate-risk prostate cancer: A systematic review and meta-analysis.

机构信息

Department of Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu, China.

Department of Radiation, the Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.

出版信息

Front Endocrinol (Lausanne). 2023 Jan 17;13:1074540. doi: 10.3389/fendo.2022.1074540. eCollection 2022.

Abstract

OBJECTIVES

Androgen deprivation therapy combined with radiotherapy for intermediate-risk prostate cancer is still a matter of debate. We conducted a meta-analysis to evaluate the necessity of androgen deprivation therapy combined with radiotherapy for intermediate-risk prostate cancer patients.

METHODS

A comprehensive literature search of articles was performed in PubMed, Embase, Cochrane library, Web of Science, Chinese National Knowledge Infrastructure, Chinese Biological Medicine, Wanfang, and VIP Databases published between February 1988 and April 2022. Studies comparing the survival of patients diagnosed with intermediate-risk prostate cancer who were treated with androgen deprivation therapy combined with radiotherapy or radiotherapy alone were included. Data were extracted and analyzed with the RevMan software (version 5.3) and the Stata software (version 17).

RESULTS

Six randomized controlled trials and nine retrospective studies, including 6853 patients (2948 in androgen deprivation therapy combined with radiotherapy group and 3905 in radiotherapy alone group) were enrolled. Androgen deprivation therapy combined with radiotherapy did not provide an overall survival (HR 1.12, 95% CI 1.01-1.12, p=0.04) or biochemical recurrence-free survival (HR 1.23, 95% CI 1.09-1.39, P=0.001) advantage to intermediate-risk prostate cancer patients.

CONCLUSION

Androgen deprivation therapy combined with radiotherapy did not show some advantages in terms of overall survival and biochemical recurrence-free survival and radiotherapy alone may be the effective therapy for intermediate-risk prostate cancer patients.

SYSTEMATIC REVIEW REGISTRATION

https://inplasy.com/inplasy-2022-8-0095/, identifier 202280095.

摘要

目的

雄激素剥夺疗法联合放疗治疗中危前列腺癌仍存在争议。我们进行了一项荟萃分析,以评估雄激素剥夺疗法联合放疗治疗中危前列腺癌患者的必要性。

方法

系统检索 1988 年 2 月至 2022 年 4 月期间在 PubMed、Embase、Cochrane 图书馆、Web of Science、中国知网、中国生物医学文献数据库、万方和维普数据库发表的文章,纳入比较雄激素剥夺疗法联合放疗或单纯放疗治疗中危前列腺癌患者生存情况的研究。采用 RevMan 软件(版本 5.3)和 Stata 软件(版本 17)提取和分析数据。

结果

纳入 6 项随机对照试验和 9 项回顾性研究,共 6853 例患者(雄激素剥夺疗法联合放疗组 2948 例,单纯放疗组 3905 例)。雄激素剥夺疗法联合放疗并未为中危前列腺癌患者带来总体生存(HR 1.12,95%CI 1.01-1.12,p=0.04)或生化无复发生存(HR 1.23,95%CI 1.09-1.39,P=0.001)优势。

结论

雄激素剥夺疗法联合放疗在总体生存和生化无复发生存方面并未显示出一些优势,单纯放疗可能是中危前列腺癌患者的有效治疗方法。

系统评价注册

https://inplasy.com/inplasy-2022-8-0095/,标识符 202280095。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b99/9887024/3d1c10bfaaec/fendo-13-1074540-g001.jpg

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