乳腺癌保乳术后常规切线野放疗与调强放疗剂量学比较的Meta分析

目的 探讨乳腺癌保乳术后调强放疗的优势及不足,为临床治疗提供有价值的循证医学依据。方法 计算机检索PubMed、EMBase、Science、中国知网和万方等数据库,筛选所有乳腺癌保乳术后常规切线野放疗与调强放疗的剂量学比较的文章,应用StataSE 12.0软件对满足条件的数据进行Meta分析。结果 本次研究纳入12篇文章。调强放疗较常规切线野放疗明显降低了靶区的均匀性指数HI(SMD=1.102,95%CI:0.699~1.504,P＜0.001),并明显降低了肺V20、肺V30、心脏V30及V40,差异均有统计学意义;而肺V5、肺V10及心脏V5的差异均无统计学意义。结论 与常规切线野放疗相比,乳腺癌保乳术后调强放疗使靶区分布更均匀,可明显降低高剂量区的照射靶体积,但并未减少低剂量区的照射靶体积,为临床治疗技术的选择提供依据。

Dosimetric comparisons of conventional tangential radiotherapy and intensity modulated radiotherapy in conservative-breast therapy:A Meta-analysis

Objective To evaluate the advantage and disadvantage of IMRT,we established this Meta-analysis which gives service to clinical therapy.Methods Clinical researches of dosimetric comparisons between CRT and IMRT for conservative-breast therapy were obtained from the Pubmed,Science,EMbase,CNKI(Zhong Guo Zhi Wang) and Wan Fang databases up to April 2015.The data calculated and analyzed using the StataSE 12.0 software.Results Twelve researches were included.Comparing to CRT,IMRT significantly decreased the homogeneity index(HI)(SMD=1.102,95%CI:0.699~1.504,P<0.001).IMRT significantly lowered the lung V20,lung V30,heart V30 and heart V40,whileas the lung V5,lung V10 and heart V5 were not lowered.Conclu-sion Comparing to CRT,IMRT achieves better homogeneity of dose distribution and reduces irradiated volumes of heart and lung in high-dose areas without decreases irradiated volumes in low-dose areas,which provides ev-idence to choose valuable clinical technique.