^(125)I对比^(103)Pd治疗低危前列腺癌的系统评价  

^(125)I versus ^(103)Pd brachytherapy for low risk prostate cancer: a systematic review

作　　者：张琳琳[1,2] 马力[2] 田金徽[1] 任尧尧[1,2] 杨克虎[1] 

机构地区：[1]兰州大学循证医学中心,兰州大学基础医学院,甘肃兰州730000 [2]天津医科大学总医院肿瘤科,天津300052

出　　处：《癌症》2009年第8期872-878,共7页Chinese Journal of Cancer

摘　　要：背景与目的:粒子植入近距离放射治疗是早期前列腺癌的主要治疗手段,常用核素粒子为125I或103Pd,二者在前列腺癌治疗的并发症和结果方面存有差异。本文用系统评价的方法分析125I与103Pd近距离放射治疗低危前列腺癌的疗效和副作用,为临床决策提供指导性依据。方法:采用文献检索和手工检索的方式搜集2008年5月以前有关125I对比103Pd治疗低危前列腺癌的随机对照试验的文献资料,根据Cochrane Handbook4.2.6质量评价标准进行评价,由两位研究者交叉核对纳入试验的结果,用RevMan5.0进行统计学分析。结果:共纳入6个随机对照研究,1406例患者。125I和103Pd治疗低危前列腺癌生物学无进展生存率差异没有统计学意义(RR=0.97,95%CI=0.93～1.01);治疗后1个月103Pd组副作用较125I组明显,治疗后6个月125I组副作用较103Pd明显,治疗后12个月两种核素副作用无差别。结论:使用125I和103Pd治疗低危前列腺癌疗效相似,副作用在治疗后不同时间点有差异。Background and Objective. Permanent interstitial prostate brachytherapy is the main treatment for early-stage prostate cancer. ^125I and ^103Pd are the most commonly used radionuclides for prostate brachytherapy, which are different in complications and clinical efficacy. This study was to compare the effectiveness and adverse effects of ^125I and ^103Pd for patients with low risk prostate cancer using transperineal prostate seed implantation. Methods：Systematic literature retrieval was carried out to obtain articles of randomized controlled trials comparing ^125I and ^103Pd brachytherapy for low risk prostate cancer before May 2008. Study selection, data collection and quality assessment of studies were performed by two individual reviewers according to the Cochrane Handbook for systematic reviews of interventions 4.2.6. Statistic analyses were calculated using RevMan5.0 software. Results; Six randomized controlled trials, a total of 1 406 patients, were included. There was no significant difference in biochemical progression free survival between patients treated with ^125I brachytherapy and those treated with ^103Pd brachytherapy [RR=0.97, 95%CI （0.93,1.01）]. At one month after seed implantation, the adverse effects were more severe in ^103Pd group than in ^125I group. At six months after seed implantation, the adverse effects were more severe in ^125I group than in ^103Pd group. No significant difference in adverse effects was found between the two groups at 12 months after seed implantation. Conclusion： The individual effects of ^125I and ^103Pd brachytherapy for low risk prostate cancer are similar. However, the side effects are different at different time points after treatment.

关 键 词：前列腺肿瘤 放射疗法 ^125I ^103PD Meta分析 系统评价 

分 类 号：R737.25[医药卫生—肿瘤] R730.55[医药卫生—临床医学]