近距离放射治疗与根治性前列腺切除术治疗局限性前列腺癌疗效的Meta分析

目的 比较近距离放射治疗与根治性前列腺切除术治疗局限性前列腺癌的疗效.方法 通过PubMed、万方、中国生物医学文献光盘数据库(CBMdisc)、荷兰医学文献数据库(EMBASE)、Ovid、Cochrane Library数据库收集已发表的有关局限性前列腺癌近距离放射治疗与根治性前列腺切除术疗效的随机对照研究文献,按预设的标准进行筛选,对纳入研究进行质量评价,并提取5年无生化复发生存率作为终点指标,使用Cochrane系统评价软件RevMan 5.0完成Meta分析.结果 经筛选,共纳入6个研究,总样本量5903例,其中近距离放疗组3323例,根治性前列腺切除术组2580例.分析结果显示2种治疗方法的5年无生化复发生存率合并OR为1.00(95％ CI:0.69～1.45),P=0.99,差异无统计学意义.结论 局限性前列腺癌近距离放射治疗与根治性前列腺切除术疗效相当,且更具优势.但纳入文献和样本量有限,今后还需增大样本,提供更好的循证证据.

Meta-analysis of comparison between brachytherapy and radical prostatectomy for the treatment oflocalized prostate cancer

Objective To compare the therapeutic effect of brachytherapy and radical prostatecto- my for localized prostate cancer using a Meta-analysis. Methods The published data with randomized con- trol trials （RCT） on comparison of brachytherapy and radical prostatectomy for the treatment of localized prostate cancer in PubMed, Wanfang database, Chinese Biomedical Literature Database （ CBMdisc）, the Excerpta Medica Database （EMBASE） , Ovid and Cochrane library were searched and screened. The quali- ty of the studies included was evaluated and the data with 5-year event free survival rate for comparison were extracted. Meta-analysis was performed by RevMan 5.0 （ Cochrane reviews software）. Results From six trials, there were 5903 patients that were eligible for the analysis, in which 3323 patients were treated by brachytherapy and other 2580 by radical prostatectomy. The odds ratio of all trials was 1.00 （95% CI：O. 69- 1.45, P = 0.99） and there was no significant difference of 5-year event free survival rate between two treat- ment groups. Conclusion This Meta analysis shews that brachytherapy may have comparable treatment effect than radical prostatectomy.