Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
J Radiat Res. 2023 Jun 16;64(Supplement_1):i34-i40. doi: 10.1093/jrr/rrad015.
Particle beam therapy (PT) is a potentially promising approach to the treatment of extrahepatic biliary cancer (EBC) because of its unique dose distribution using the Bragg peak. However, the superiority of PT to photon radiotherapy (XT) remains unclear. Therefore, we conducted a systematic review and meta-analysis to compare PT and XT for the treatment of EBC. The primary endpoint was overall survival (OS), which was pooled using a random-effects model. Nine articles comprising a total of 1558 patients (seven XT articles, n = 1488 patients; two PT articles, n = 70 patients) were screened. In addition, we compared the outcomes of XT and PT with the outcomes available from a prospective data registry (proton-net). The 1-year OS probability rates were 55, 65 and 72% for the XT group, PT group and PT registry, respectively. The 2-year OS probability rates were 26, 38 and 38% for the XT group, PT group and PT registry, respectively. The 3-year OS probability rates were 12, 35 and 18% for the XT group, PT group and PT registry, respectively. Although the difference between the 1-year OS rates of the XT group and PT registry was statistically significant, no other significant superiority was observed among these groups. In conclusion, the efficacy of PT was not superior to that of XT during this meta-analysis.
粒子束治疗（PT）是一种治疗肝外胆管癌（EBC）的有前途的方法，因为它使用布拉格峰具有独特的剂量分布。然而，PT 优于光子放射治疗（XT）的优势尚不清楚。因此，我们进行了一项系统评价和荟萃分析，比较了 PT 和 XT 治疗 EBC 的效果。主要终点是总生存期（OS），采用随机效应模型进行汇总。筛选出了 9 篇文章，共纳入了 1558 名患者（7 篇 XT 文章，n=1488 名患者；2 篇 PT 文章，n=70 名患者）。此外，我们还将 XT 和 PT 的结果与质子网（proton-net）前瞻性数据登记处的结果进行了比较。XT 组、PT 组和 PT 登记组的 1 年 OS 概率分别为 55%、65%和 72%。XT 组、PT 组和 PT 登记组的 2 年 OS 概率分别为 26%、38%和 38%。XT 组、PT 组和 PT 登记组的 3 年 OS 概率分别为 12%、35%和 18%。尽管 XT 组和 PT 登记组 1 年 OS 率之间的差异具有统计学意义，但这些组之间没有观察到其他显著优势。总之，在本荟萃分析中，PT 的疗效并不优于 XT。
