Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Cancer Med. 2024 Feb;13(3):e7023. doi: 10.1002/cam4.7023.
This study aimed to compare the outcomes of proton beam therapy (PBT) and carbon ion radiotherapy (CIRT) by a systematic review and meta-analysis of the existing clinical evidence.
A systematic literature search was performed to identify studies comparing the clinical outcomes of PBT and CIRT. The included studies were required to report oncological outcomes (local control [LC], progression-free survival [PFS], or overall survival [OS]) or adverse events.
Eighteen articles comprising 1857 patients (947 treated with PBT and 910 treated with CIRT) were included in the analysis. The pooled analysis conducted for the overall population yielded average hazard ratios of 0.690 (95% confidence interval (CI), 0.493-0.967, p = 0.031) for LC, 0.952 (95% CI, 0.604-1.500, p = 0.590) for PFS, and 1.183 (0.872-1.607, p = 0.281) for OS with reference to CIRT. The subgroup analyses included patients treated in the head and neck, areas other than the head and neck, and patients with chordomas and chondrosarcomas. These analyses revealed no significant differences in most outcomes, except for LC in the subgroup of patients treated in areas other than the head and neck. Adverse event rates were comparable in both groups, with an odds ratio (OR) of 1.097 (95% CI, 0.744-1.616, p = 0.641). Meta-regression analysis for possible heterogeneity did not demonstrate a significant association between treatment outcomes and the ratio of biologically effective doses between modalities.
This study highlighted the comparability of PBT and CIRT in terms of oncological outcomes and adverse events.
本研究旨在通过对现有临床证据的系统评价和荟萃分析，比较质子束治疗（PBT）和碳离子放疗（CIRT）的结果。
系统地检索文献，以确定比较 PBT 和 CIRT 临床结果的研究。纳入的研究需报告肿瘤学结果（局部控制[LC]、无进展生存期[PFS]或总生存期[OS]）或不良事件。
纳入的 18 篇文章共包括 1857 例患者（947 例接受 PBT 治疗，910 例接受 CIRT 治疗）。对总体人群进行的荟萃分析得出，LC 的平均危险比为 0.690（95%置信区间[CI]，0.493-0.967，p=0.031），PFS 为 0.952（95%CI，0.604-1.500，p=0.590），OS 为 1.183（95%CI，0.872-1.607，p=0.281），以 CIRT 为参照。亚组分析包括头颈部和头颈部以外部位的患者，以及脊索瘤和软骨肉瘤患者。这些分析显示，除了头颈部以外部位的患者的 LC 外，大多数结果没有显著差异。两组的不良事件发生率相当，优势比（OR）为 1.097（95%CI，0.744-1.616，p=0.641）。对可能的异质性进行的元回归分析表明，治疗结果与两种模式之间的生物有效剂量比之间没有显著关联。
本研究强调了 PBT 和 CIRT 在肿瘤学结果和不良事件方面的可比性。
