CT引导下放射性125Ⅰ粒子植入治疗中晚期胰腺癌的有效性和安全性的Meta分析  

Efficacy and safety of CT-guided 12sI seed implantation for treatment of advanced pancreatic cancer： a Meta-analysis

作　　者：汪浩[1] 霍彬[1] 霍小东[1] 王丽丽[1] 侯定坤[1] 臧立[1] 王金焕[1] 柴树德[2] 王俊杰[3] 王海涛[1] 

机构地区：[1]天津医科大学第二医院肿瘤科,300211 [2]天津医科大学第二医院胸外科,300211 [3]北京大学第三医院肿瘤放疗科,100191

出　　处：《中华放射医学与防护杂志》2017年第7期543-549,共7页Chinese Journal of Radiological Medicine and Protection

基　　金：国家自然科学基金（81572543）;国家肿瘤临床医学研究中心个体化医学平台建设项目（13ZCZCSY20300）

摘　　要：目的 系统评价放射性 125Ⅰ粒子植入治疗中晚期胰腺癌的有效性和安全性。方法 检索中国知网（CNKI）、万方数据库、中国生物医学文献数据库（CBM）及Cochrane Library、PubMed、Embase，收集有关 125Ⅰ粒子植入治疗胰腺癌的随机对照试验（RCT），检索时限均为从建库至2016年11月。由2名研究者独立筛选文献、提取数据和评价纳入研究的质量后，采用RevMan5.3软件进行Meta分析。结果 按照纳入标准，共纳入12篇研究，689 例患者。 125Ⅰ粒子植入组患者的总体客观缓解率（OR=3.24，95%CI 2.33~4.52，P〈0.001）、6个月生存率（OR=3.61，95%CI 1.53~8.52，P=0.003）、12个月生存率（OR=4.80~95%CI 2.40，9.57，P〈0.001）和疼痛缓解率（OR=4.79，95%CI 2.58~8.89，P〈0.001）均显著优于对照组，但两组之间的2年生存率（OR=2.36，95%CI 0.47~11.74，P=0.29）和总体不良反应发生率（OR=4.94，95%CI 1.05~23.23，P=0.04）差异无统计学意义。结论 125Ⅰ粒子植入治疗中晚期胰腺癌是一种安全有效的治疗策略，可以显著提高患者的客观缓解率、短期生存率和疼痛缓解率，除粒子移位外，并未明显增加相关不良反应的发生率。 但是，目前所纳入研究的数量及质量均有限，有待进一步开展高质量的临床研究。Objective To systematically evaluate the efficacy and safety of 125Ⅰ seed implantation for treatment of advanced pancreatic cancer. Methods An electronic literature search was performed about randomized controlled trials（RCTs） of 125Ⅰ implantation for treamtent of advanced pancreatic cancer in CNKI, Wanfang Data, CBM, Cochrane Library, PubMed and Embase （from the date of building the database to November 2016）. Two investigators independently screened literature, extracted data and assessed the risk bias of included studies, and the Meta-analysis was performed by using Revman 5.3 software. Results There were 12 RCTs （n=689） included. Meta-analysis showed that the objective respond rate（ORR） （OR=3.24, 95%CI 2.33-4.52, P〈0.001）, the 6-month survival rate（OR=3.61, 95%CI 1.53-8.52, P=0.003）, the 12-month survival rate（OR=4.80, 95%CI 2.40-9.57, P〈0.001） and the relief rate of pain were higher than those in the control group. However, there were no significant differences between both groups in the 2-year survival rate and the adverse reaction rate, which were （OR=2.36, 95%CI 0.47-11.74, P=0.29） and （OR=4.94, 95%CI 1.05-23.23, P=0.04）, respectively. Conclusions The limited current evidence showed that 125Ⅰ implantation for treatment of advanced pancreatic cancer is effective and safety. 125Ⅰ implantation can improve the ORR, short-time survival rate and pain relief rate. In addition, there was no significant increase in the incidence of related adverse events except for seed malposition. Although the quality and quantity of evidences is limited, it merits further study to provide high quality evidences.

关 键 词：125Ⅰ粒子 近距离放射治疗 胰腺癌 系统评价 META分析 

分 类 号：R735.9[医药卫生—肿瘤]