HPV阳性口咽癌低剂量与标准剂量放疗疗效比较的meta分析  

Meta-analysis of comparison of efficacies between low-dose and standard-dose radiotherapy in human papillomavirus-associated oropharyngeal cancer

作　　者：郝杰文 温树信[1] 张丽[2] 王晨[1] 车顺途 李俊隆 罗梅方 Hao Jiewen;Wen Shuxin;Zhang Li;Wang Chen;Che Shuntu;Li Junlong;Luo Meifang(Department of Otolaryngology Head and Neck Surgery,Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan 030032,China;Department of Head and Neck Surgery,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences(Cancer Hospital Affiliated to Shanxi Medical University),Taiyuan 030001,China)

机构地区：[1]山西医科大学第三医院(山西白求恩医院、山西医学科学院、同济山西医院)耳鼻咽喉头颈外科,太原030032 [2]中国医学科学院肿瘤医院山西医院(山西医科大学附属肿瘤医院)头颈外科,太原030001

出　　处：《中华放射肿瘤学杂志》2024年第7期599-605,共7页Chinese Journal of Radiation Oncology

摘　　要：目的比较低剂量放疗(LD-RT)与标准剂量放疗(SD-RT)治疗人乳头瘤病毒(HPV)阳性口咽癌患者的疗效及安全性。方法检索PubMed、Web of Science、Cochrane Library、EMbase、中国生物医学文献数据库、中国知网、维普、万方数据库中,2000年1月1日至2023年2月9日期间,所有对比研究低剂量与标准剂量放疗治疗HPV阳性口咽癌的文献。按照纳入与排除标准进行严格的筛选,提取资料,采用RevMan 5.4软件进行meta分析。结果最终纳入8篇文献,汇总结果表明LD-RT组患者的总生存(OS)期和无进展生存(PFS)期与SD-RT组基本一致(HR=0.83,95%CI为0.59~1.18,P=0.31;HR=0.97,95%CI为0.53~1.78,P=0.92),但经皮内镜胃造瘘管(PEG)置管率显著降低(RR=0.45,95%CI为0.28~0.72,P=0.001)。结论LD-RT可使HPV阳性口咽癌患者获得与SD-RT相当的疗效和更低的PEG置管率。Objective To compare the efficacy and safety of low-dose and standard-dose radiotherapy(LD-RT vs.SD-RT)in the treatment of oropharyngeal cancer patients with positive human papillomavirus(HPV).Methods All comparative studies of low-dose versus standard-dose radiotherapy in the treatment of HPV-positive oropharyngeal cancer were searched from PubMed,Web of Science,Cochrane Library,EMbase,Chinese Biomedical Literature Database(CBM),CNKI,Chongqing VIP,and Wanfang databases from January 1,2000 to February 9,2023.According to the inclusion and exclusion criteria,the data were strictly screened,and the RevMan 5.4 software was used for meta-analysis.Results A total of 8 studies were included.The pooled results showed that the overall survival(OS)and progression-free survival(PFS)of patients in the LD-RT group were similar to those in the SD-RT group(HR=0.83,95%CI=0.59-1.18,P=0.31;HR=0.97,95%CI=0.53-1.78,P=0.92),but the rate of percutaneous endoscopic gastrostomy(PEG)insertion was significantly reduced(RR=0.45,95%CI=0.28-0.72,P=0.001).Conclusion LD-RT yields similar efficacy and lower rate of PEG insertion compared with SD-RT in HPV-positive oropharyngeal neoplasm patients.

关 键 词：口咽肿瘤 人乳头瘤病毒 放射疗法 低剂量 META分析 

分 类 号：R739.63[医药卫生—肿瘤]