中华放射医学与防护杂志

杨烨,侯彦杰,薛少军,刘焕茹,李险峰.前列腺癌放疗患者植入水凝胶后对直肠保护作用的Meta分析[J].中华放射医学与防护杂志,2021,41(6):436-443

前列腺癌放疗患者植入水凝胶后对直肠保护作用的Meta分析

The protective effects of hydrogel implantation in prostate cancer patients for radiotherapy: a Meta-analysis

投稿时间：2020-12-07

DOI：10.3760/cma.j.issn.0254-5098.2021.06.007

英文关键词:Prostate cancer Hydrogel Radiotherapy Meta-analysis

基金项目:安徽省自然科学基金（1908085MA27）；安徽省重点研究与开发计划（1804a09020039）

作者	单位	E-mail
杨烨	山西医科大学第一医院放疗科, 太原 030000
侯彦杰	山西医科大学第一医院放疗科, 太原 030000
薛少军	山西医科大学第一医院放疗科, 太原 030000
刘焕茹	山西医科大学第一医院放疗科, 太原 030000
李险峰	山西医科大学第一医院放疗科, 太原 030000	lixianfeng-lxf@263.net

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中文摘要:

目的评估前列腺癌放疗患者植入水凝胶后对直肠保护作用。方法从PubMed、Web of Science、Cochrane Library、Embase、CNKI和维普数据库中检索前列腺癌患者植入水凝胶后放疗对照试验的相关文献，使用Revman 5.3统计软件对直肠V₇₀、直肠D_{2 cm³}、肠道不良反应（早期≤3个月，晚期>3个月）以及患者生活质量进行Meta分析。结果共纳入10项临床对照研究，包括1 360例患者（水凝胶组690例，对照组670例）。Meta分析结果显示，前列腺癌患者植入水凝胶后直肠V₇₀、直肠D_{2 cm³}较对照组明显下降（MD=-4.5，95%CI-7.11~-1.90，P<0.001；MD=-19.78，95%CI-25.92~-13.63，P<0.001），早期和晚期G1肠道不良反应较对照组明显改善（OR=0.64，95%CI 0.45~0.90，P=0.01；OR=0.28，95%CI 0.13~0.60，P=0.001），晚期患者生活质量较对照组明显提高（MD=5.13，95%CI 3.29~6.98，P<0.001），差异均具有统计学意义；植入水凝胶后早期及晚期≥G2肠道不良反应两组相近（OR=0.46，95%CI 0.17~1.25，P=0.13；OR=0.44，95%CI 0.09~2.17，P=0.31），早期患者生活质量两组相近，差异均无统计学意义（MD=2.30，95%CI-1.31~5.91，P=0.21）。结论前列腺癌患者植入水凝胶后放疗，可以降低直肠V₇₀、直肠D_{2 cm³}，改善早期和晚期G1肠道不良反应，提高晚期患者生活质量。

英文摘要:

Objective To evaluate the protective effects of hydrogel implantation in prostate cancer patients for radiotherapy. Methods A search was performed in PubMed, Web of Science, Cochrane Library, Embase, CNKI and VIP to collect controlled clinical research literature concerning hydrogel implantation in prostate cancer for radiotherapy. The Revman 5.3 software was used to perform meta-analyses of rectal V₇₀, rectal D_{2 cm³}, rectal toxicity effects and bowel symptoms. Results The review included ten controlled clinical trials involving 1 360 patients (690 in the hydrogel group and 670 in the control group). The result of Meta-analysis showed that the rectal V₇₀ and rectal D_{2 cm³} of prostate cancer patients in the hydrogel group were significantly lower than those in the control group(MD=-4.5,95%CI -7.11 to -1.90,P<0.001;MD=-19.78,95%CI -25.92 to -13.63,P<0.001), early and late G1 rectal toxic effects in the hydrogel group were significantly lower than those in the control group (OR=0.64,95%CI 0.45-0.90,P=0.01;OR=0.28,95%CI 0.13-0.60,P=0.001)and the late bowel quality of life in the hydrogel group was significantly improved compared with the control group(MD=5.13,95%CI 3.29-6.98,P<0.001). However, there were no statistically significant differences in early and late ≥G2 rectal toxic effects(OR=0.46,95%CI 0.17-1.25,P=0.13;OR=0.44,95%CI 0.09-2.17,P=0.31) and the early bowel symptoms(MD=2.30,95%CI -1.31-5.91,P=0.21) between the two groups. Conclusions Hydrogel implantation inprostate cancer for radiotherapy can reduce rectal V₇₀ and rectal D_{2 cm³}, lower the early and late G1 rectal toxic effects, and reduce improve the late bowel symptoms.

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