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一项关于颅底软骨肉瘤放射治疗和粒子束治疗的系统评价与荟萃分析:TRP-软骨肉瘤2024。

A systematic review and meta-analysis of radiotherapy and particle beam therapy for skull base chondrosarcoma: TRP-chondrosarcoma 2024.

作者信息

Nakamura Masatoshi, Mizumoto Masashi, Saito Takashi, Shimizu Shosei, Li Yinuo, Oshiro Yoshiko, Inaba Masako, Hosaka Sho, Fukushima Hiroko, Suzuki Ryoko, Iizumi Takashi, Nakai Kei, Maruo Kazushi, Sakurai Hideyuki

机构信息

Department of Radiation Oncology, University of Tsukuba, Tsukuba, Japan.

Department of Pediatric Radiation Therapy Center/Pediatric Proton Beam Therapy Center, Hebei Yizhou Cancer Hospital, Zhuozhou, China.

出版信息

Front Oncol. 2024 Mar 19;14:1380716. doi: 10.3389/fonc.2024.1380716. eCollection 2024.

Abstract

INTRODUCTION

Chondrosarcoma is a rare malignant bone tumor. Particle beam therapy (PT) can concentrate doses to targets while reducing adverse events. A meta-analysis based on a literature review was performed to examine the efficacy of PT and photon radiotherapy for skull base chondrosarcoma.

METHODS

The meta-analysis was conducted using 21 articles published from 1990 to 2022.

RESULTS

After PT, the 3- and 5-year overall survival (OS) rates were 94.1% (95% confidence interval [CI]: 91.0-96.2%) and 93.9% (95% CI: 90.6-96.1%), respectively, and the 3- and 5-year local control rates were 95.4% (95% CI: 92.0-97.4%) and 90.1% (95% CI: 76.8-96.0%), respectively. Meta-regression analysis revealed a significant association of PT with a superior 5-year OS rate compared to three-dimensional conformal radiotherapy (p < 0.001). In the studies used in the meta-analysis, the major adverse event of grade 2 or higher was temporal lobe necrosis (incidence 1-18%, median 7%).

CONCLUSION

PT for skull base chondrosarcoma had a good outcome and may be a valuable option among radiotherapy modalities. However, high-dose postoperative irradiation of skull base chondrosarcoma can cause adverse events such as temporal lobe necrosis.

摘要

引言

软骨肉瘤是一种罕见的恶性骨肿瘤。粒子束治疗(PT)可将剂量集中于靶区,同时减少不良事件。基于文献综述进行了一项荟萃分析,以研究PT和光子放疗对头颈部软骨肉瘤的疗效。

方法

使用1990年至2022年发表的21篇文章进行荟萃分析。

结果

PT治疗后,3年和5年总生存率(OS)分别为94.1%(95%置信区间[CI]:91.0-96.2%)和93.9%(95%CI:90.6-96.1%),3年和5年局部控制率分别为95.4%(95%CI:92.0-97.4%)和90.1%(95%CI:76.8-96.0%)。荟萃回归分析显示,与三维适形放疗相比,PT与更高的5年OS率显著相关(p<0.001)。在荟萃分析中使用的研究中,2级或更高等级的主要不良事件是颞叶坏死(发生率1-18%,中位数7%)。

结论

PT治疗头颈部软骨肉瘤效果良好,可能是放疗方式中的一个有价值的选择。然而,头颈部软骨肉瘤术后高剂量照射可导致颞叶坏死等不良事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7955/10985235/1b699c84d1f8/fonc-14-1380716-g001.jpg

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