食管癌适形与调强放疗技术剂量参数比较的Meta分析  

Dosimetric parameters between three-dimensional conformal radiotherapy and intensity modulated radiotherapy for esophageal cancer radiotherapy: A Meta-analysis

作　　者：姜世文[1] 赵佳莹[1] 钟文[1] 刘丹[1] 郭根燕[1] 廖娇[1] 孙岩[1] 陈艳艳[1] 陈延治[1] 赵玉霞[1] 

机构地区：[1]中国医科大学附属第四医院放疗科,辽宁沈阳110032

出　　处：《现代肿瘤医学》2016年第4期566-571,共6页Journal of Modern Oncology

基　　金：辽宁省省直医院改革重点临床科室诊疗能力建设项目(编号:LNCCC-B08-2014)

摘　　要：目的:探讨食管癌三维适形放疗(three-dimensional conformal radiotherapy,3D-CRT)与调强放疗(intensity modulated radiotherapy,IMRT)技术间的剂量参数差异,为临床提供有价值的循证医学证据。方法:计算机检索Cochrane、PubMed、Embase及中国知网(CNKI)、万方数据库中所有比较食管癌三维适形放疗及调强放疗的文章,应用RevMan 5.2软件对所有满足条件的数据进行Meta分析。结果:17篇文献纳入本次研究。食管癌调强放疗与适形放疗比,能显著降低双肺的V_(20)(MD=4.63,95%CI:1.69~7.56,P<0.01)及V_(30)。(MD=4.21,95%CI:1.48~6.94,P<0.01),且有更好的适形指数(MD=-0.14,95%CI:-0.2^-0.07,P<0.01)及均匀指数(MD=0.04,95%CI:-0.01~0.07,P<0.01);双肺V_5、V_(10)、心脏V_(40)及脊髓最大受量D_(max)两种放疗技术间无统计学差异。结论:食管癌IMRT与3D—CRT比较能明显降低肺的V_(20)及V_(30),具有更好的靶区适形度。Objective：To evaluate the differences of parameters of organs at risk（OAR） between three- dimensional conformal radiotherapy（3D- CRT） and intensity modulated radiotherapy（IMRT） for esophageal cancer radiotherapy and provide more valuable evdiences to the clinical researches.Methods：We electronically searched publications from CNKI,Wanfang,PubMed,Embase.The data included in the study were evaluated and analyzed using the Cochrane Collaboration＇s RevMan 5.2 software.Results：Seventeen trials were included.Compared to 3D- CRT group,the lung V_（20）,V_（30） and homogeneity index（HI） significantly decreased and conformity index（CI） increased in IMRT group.（V_（20）：MD=4.63,95%CI：1.69~7.56,P〈0.01,V_（30）：MD=4.21,95%CI：1.48-6.94,P〈0.01,HI：MD=0.04 95%CI：-0.01~0.07,P〈0.01;CI：MD=-0.14 95%CI：-0.2^-0.07,P〈0.01）.But there was no statistically significant difference in the lung V_5 Jung V_（10）.heart V_（40） and spinal cord D_（max）.Conclusion：Compared to3D-CRT Jung V_（20） and V_（30） could be reduced sinificantly with IMRT in esophageal cancer radiotherapy.

关 键 词：食管癌 放疗技术 调强放疗 三维适形放疗 剂量学 META分析 

分 类 号：R735.1[医药卫生—肿瘤]