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

doi:10.11904/j.issn.1002-3070.2016.01.003

实用肿瘤学杂志 ›› 2016, Vol. 30 ›› Issue (1): 11-16.doi: 10.11904/j.issn.1002-3070.2016.01.003

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

孙岩, 崔芹玲, 钟文, 郭根燕, 赵佳莹, 姜世文, 陈延治, 赵玉霞

辽宁省沈阳市中国医科大学附属第四医院放疗科(沈阳 110032)

收稿日期:2015-09-25 出版日期:2016-02-28 发布日期:2016-02-25
通讯作者: 赵玉霞,E-mail:zyx_yd@163.com
作者简介:孙岩,女,(1989-),硕士研究生,从事乳腺癌放疗的研究
基金资助:
辽宁省省直医院改革重点临床科室诊疗能力建设项目(LNCCC-B08-2014);辽宁省博士启动基金项目(20131138)

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

SUN Yan, CUI Qinling, ZHONG Wen, GUO Genyan, ZHAO Jiaying, JIANG Shiwen, CHEN Yanzhi, ZHAO Yuxia

Department of Radiation Oncology of Cancer Center,Fourth Affiliated Hospital of China Medical University,Shenyang 110032,China

Received:2015-09-25 Online:2016-02-28 Published:2016-02-25

摘要/Abstract

摘要： 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。

关键词: 乳腺癌, 保乳术, 放疗, 剂量学比较, Meta分析

Abstract: 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.Conclusion 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 evidence to choose valuable clinical technique.

Key words: Breast cancer, Conservative surgery, Radiotherapy, Dosimetric comparison, Meta-analysis

中图分类号:

R737.9

孙岩, 崔芹玲, 钟文, 郭根燕, 赵佳莹, 姜世文, 陈延治, 赵玉霞. 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[J]. 实用肿瘤学杂志, 2016, 30(1): 11-16.

SUN Yan, CUI Qinling, ZHONG Wen, GUO Genyan, ZHAO Jiaying, JIANG Shiwen, CHEN Yanzhi, ZHAO Yuxia. Dosimetric comparisons of conventional tangential radiotherapy and intensity modulated radiotherapy in conservative-breast therapy:A Meta-analysis[J]. PRACTICAL ONCOLOGY JOURNAL, 2016, 30(1): 11-16.

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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

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

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