中国医药导报
中國醫藥導報
중국의약도보
China Medical Herald
2015年
26期
90-95
,共6页
脑转移瘤%全脑放疗%立体定向放疗%Meta分析
腦轉移瘤%全腦放療%立體定嚮放療%Meta分析
뇌전이류%전뇌방료%입체정향방료%Meta분석
Brain metastases tumor%Whole brain radiation therapy%Stereotactic radiotherapy%Meta analysis
目的：对比分析全脑放疗(WBRT)联合立体定向放疗(SRS)与单独SRS治疗脑转移瘤效果。方法通过检索Pubmed、Cochrane图书馆、Embase、中国生物医学文献数据库、中文科技期刊数据库以及中国期刊全文数据库等在线数据库,收集SRS联合与不联合WBRT治疗脑转移瘤的随机临床对照研究并由两名评价者对疗效及安全性有关数据进行提取及质量评估,采用RevMan 5.3软件进行Meta分析。结果经过系统筛选,最终纳入5篇文献,472例脑转移瘤患者。盲法缺失影响纳入研究的总体质量。合并分析结果表明院与单独SRS相比,WBRT联合SRS在提高1年颅内疾病无进展生存方面差异有统计学意义(OR =3.66,95%CI 1.80~7.45,P=0.0003)。 SRS联合与不联合WBRT对改善1年总体生存率(OR =0.78,95%CI 0.24~2.52,P=0.6700)及2年总体生存率差异无统计学意义(OR =1.12,95%CI 0.35~3.55,P=0.8500)。生存分析表明,SRS联合与不联合WBRT对总体生存率的影响差异无统计学意义(HR =1.17,95%CI 0.96~1.41,P=0.1100)。结论 WBRT联合SRS用于治疗脑转移瘤,可显著降低脑转移瘤进展风险,但对总体生存时间无显著改善。
目的：對比分析全腦放療(WBRT)聯閤立體定嚮放療(SRS)與單獨SRS治療腦轉移瘤效果。方法通過檢索Pubmed、Cochrane圖書館、Embase、中國生物醫學文獻數據庫、中文科技期刊數據庫以及中國期刊全文數據庫等在線數據庫,收集SRS聯閤與不聯閤WBRT治療腦轉移瘤的隨機臨床對照研究併由兩名評價者對療效及安全性有關數據進行提取及質量評估,採用RevMan 5.3軟件進行Meta分析。結果經過繫統篩選,最終納入5篇文獻,472例腦轉移瘤患者。盲法缺失影響納入研究的總體質量。閤併分析結果錶明院與單獨SRS相比,WBRT聯閤SRS在提高1年顱內疾病無進展生存方麵差異有統計學意義(OR =3.66,95%CI 1.80~7.45,P=0.0003)。 SRS聯閤與不聯閤WBRT對改善1年總體生存率(OR =0.78,95%CI 0.24~2.52,P=0.6700)及2年總體生存率差異無統計學意義(OR =1.12,95%CI 0.35~3.55,P=0.8500)。生存分析錶明,SRS聯閤與不聯閤WBRT對總體生存率的影響差異無統計學意義(HR =1.17,95%CI 0.96~1.41,P=0.1100)。結論 WBRT聯閤SRS用于治療腦轉移瘤,可顯著降低腦轉移瘤進展風險,但對總體生存時間無顯著改善。
목적：대비분석전뇌방료(WBRT)연합입체정향방료(SRS)여단독SRS치료뇌전이류효과。방법통과검색Pubmed、Cochrane도서관、Embase、중국생물의학문헌수거고、중문과기기간수거고이급중국기간전문수거고등재선수거고,수집SRS연합여불연합WBRT치료뇌전이류적수궤림상대조연구병유량명평개자대료효급안전성유관수거진행제취급질량평고,채용RevMan 5.3연건진행Meta분석。결과경과계통사선,최종납입5편문헌,472례뇌전이류환자。맹법결실영향납입연구적총체질량。합병분석결과표명원여단독SRS상비,WBRT연합SRS재제고1년로내질병무진전생존방면차이유통계학의의(OR =3.66,95%CI 1.80~7.45,P=0.0003)。 SRS연합여불연합WBRT대개선1년총체생존솔(OR =0.78,95%CI 0.24~2.52,P=0.6700)급2년총체생존솔차이무통계학의의(OR =1.12,95%CI 0.35~3.55,P=0.8500)。생존분석표명,SRS연합여불연합WBRT대총체생존솔적영향차이무통계학의의(HR =1.17,95%CI 0.96~1.41,P=0.1100)。결론 WBRT연합SRS용우치료뇌전이류,가현저강저뇌전이류진전풍험,단대총체생존시간무현저개선。
Objective To evaluate the efficacy and safety of WBRT combined with SRS versus SRS alone for the treat-ment of brain metastases. Methods Online databases including Pubmed, Embase, the Cochrane library, the Chinese biomedical literature database, China Scientific Journal Database and Chinese Journal Full-text Database were searched, and randomized controlled clinical trials relevant to treatment of brain metastases by SRS and/or WBRT were identified. Data of curative effect and safety were extracted and quality assessment was performed by two reviewers in-dependently. RevMan 5.3 software was used for the final combination analysis. Results A total of 5 articles involving 472 cases of patients with brain metastases were included. The bias of loss of blinding was the main source of low quality with regards to the overall quality of included studies. The results of the Meta-analysis showed that compared with the SRS alone, WBRT plus SRS was significantly more superior in controlling the 1-year intracranial disease pro-gression-free survival, the difference was statistically significant (OR = 3.66, 95%CI 1.80-7.45, P= 0.0003). SRS in combination with WBRT failed to significantly improve the 1-year overall survival, the difference was statistically sig-nificant (OR =0.78, 95%CI 0.24-2.52, P=0.6700), and 2-year overall survival, the difference was statistically signifi-cant (OR = 1.12, 95%CI 0.35-3.55, P= 0.8500). Pooled survival analysis showed that neither SRS plus WBRT nor SRS was significantly effective in improving overall survival, the difference was statistically significant (HR = 1.17, 95%CI 0.96-1.41, P=0.1100). Adding WBRT to SRS had no obvious effect on neural function, quality of life, and in-cidence of neurological adverse events. Conclusion WBRT plus SRS can significantly improve the 1-year intracranial disease progression-free survival, but has limited improvement on overall survival for patients with brain metastases.
