碳离子和质子治疗胰腺癌安全性和有效性的系统评价及Meta分析

目的评价碳离子和质子治疗胰腺癌(PaC)的安全性和有效性。方法检索数据库纳入碳离子和质子治疗PaC的临床研究,检索时间为自建库至2019年6月。两位研究者独立筛选文献、提取资料。采用STATA 12.0和MetaAnalyst Beta 3.13软件进行Meta分析。结果共纳入8篇文献,包含459例PaC患者。效应模型Meta分析显示,碳离子和质子治疗PaC的2、3、5级胃肠道溃疡发生率分别为7%、2%、0;2、3、4级厌食症发生率分别为6%、3%、0;1、2年总生存率(OS)分别为77%、45%;2年局部控制率为81%;1年无局部进展率为88%;1年局部复发率为15%。碳离子和质子治疗PaC的2、3、2～3级胃肠道溃疡发生率分别为6.8%、1.5%、9.2%和3.5%、8.3%、6.1%(均P>0.05);1、2年OS分别为77.1%、44.4%和77.6%、49.7%(P均>0.05)。结论碳离子和质子治疗PaC安全有效,两者的安全性和有效性相似。

Safety and Efficacy of Carbon Ion and Proton Therapies for Pancreatic Cancer: A Systematic Review and Meta-analysis

Objective To evaluate the safety and efficacy of carbon ion and proton therapies for pancreatic cancer (PaC). Methods The databases were electronically searched to collect the studies about the carbon ion and proton therapies for PaC from inception to June 2019. Two reviewers independently screened literature and extracted data. A Meta-analysis was performed by STATA 12.0 and MetaAnalyst Beta 3.13 software. Results A total of 8 studies involving 459 PaC patients were included. The incidence of grade 2, 3 and 5 gastrointestinal (GI) ulcer toxicities in PaC patients treated with carbon ion and proton therapies were 7%, 2% and 0; the incidence of grade 2, 3 and 4 anorexia toxicities were 6%, 3.2% and 0; the 1- and 2-year OS rates were 77% and 45%; the 2-year local control (LC), 1-year freedom from local progression (FFLP) and 1-year local recurrence(LR) rates were 81%, 88% and 15%. The incidence of grade 2, 3, 2-3 GI ulcer toxicities in carbon ion and proton therapies for PaC were 6.8%, 1.5%, 9.2% and 3.5%, 8.3%, 6.1% (P>0.05); and the 1- and 2-year OS were 77.1%, 44.4% and 77.6%, 49.7% (P>0.05). Conclusion Carbon ion and proton therapies for PaC are safe and effective; and the security and effectiveness of the two methods are similar.