Adjuvant and salvage radiotherapy after prostatectomy: a systematic review and meta-analysis.
Adjuvant and salvage radiotherapy after prostatectomy: a systematic review and meta-analysis.
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前列腺切除术后的辅助和挽救性放射治疗：系统评价和荟萃分析。
DOI：
10.1371/journal.pone.0104918
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Huang J
中科院分区：
文献类型：
--
作者：
Chen C;Lin T;Zhou Y;Li D;Xu K;Li Z;Fan X;Zhong G;He W;Chen X;He X;Huang J
在根治性前列腺切除术(RP)后有不良预后因素(APF)的男性中，最合适的放射治疗时间仍然是一个有争议的主题。我们进行了系统回顾和荟萃分析，以评估治疗策略：辅助放射治疗(ART)和挽救放射治疗(SRT)。我们全面检索PubMed、EMBASE、Web of Science和Cochrane图书馆，对所有随机对照试验(RCT)进行荟萃分析，并进行回顾性比较研究，评估ART和SRT的预后因素。在1998年5月至2012年7月期间，确定了2项配对对照研究和16项回顾性研究，共2629例(1404例ART和1185例SRT)。ART组的5年无生化失败生存期(BFF)明显长于SRT组(危险比：0.37；95%CI，0.30~0.46；P<；0.00001，I2 = 0%)。在ART中，3年的BFF显著延长(HR：0.38；95%CI，0.28-0.52；P<；0.00001，I2 = 0%)。总生存率(OS)较好(RR：0.53；95%CI，0.41~0.68；P<；0.00001，I2 = 0%)；无病生存率(DFS)(RR：0.53；95%CI，0.43~0.66；P<；0.00001，I2 = 0%)。探索性亚组分析和敏感性分析结果与原始分析结果基本一致。ART疗法提供了一种安全有效的SRT替代方案，具有更长的3年和5年BFF，更好的OS和DFS。我们的建议是为APFS患者推荐ART，并可能减少SRT的需要。考虑到纳入研究的内在局限性，未来设计良好的随机对照试验还有待于证实和更新这一分析。
In men with adverse prognostic factors (APFs) after radical prostatectomy (RP), the most appropriate timing to administer radiotherapy remains a subject for debate. We conducted a systemic review and meta-analysis to evaluate the therapeutic strategies: adjuvant radiotherapy (ART) and salvage radiotherapy (SRT). We comprehensively searched PubMed, EMBASE, Web of Science and the Cochrane Library and performed the meta-analysis of all randomized controlled trials (RCTs) and retrospective comparative studies assessing the prognostic factors of ART and SRT. Between May 1998 and July 2012, 2 matched control studies and 16 retrospective studies including a total of 2629 cases were identified (1404 cases for ART and 1185 cases for SRT). 5-year biochemical failure free survival (BFFS) for ART was longer than that for SRT (Hazard Ratio [HR]: 0.37; 95% CI, 0.30–0.46; p<0.00001, I2 = 0%). 3-year BFFS was significantly longer in the ART (HR: 0.38; 95% CI, 0.28–0.52; p<0.00001, I2 = 0%). Overall survival (OS) was also better in the ART (RR: 0.53; 95% CI, 0.41–0.68; p<0.00001, I2 = 0%), as did disease free survival (DFS) (RR: 0.53; 95% CI, 0.43–0.66; p<0.00001, I2 = 0%). Exploratory subgroup analysis and sensitivity analysis revealed the similar results with original analysis. ART therapy offers a safe and efficient alternative to SRT with longer 3-year and 5-year BFFS, better OS and DFS. Our recommendation is to suggest ART for patients with APFs and may reduce the need for SRT. Given the inherent limitations of the included studies, future well-designed RCTs are awaited to confirm and update this analysis.
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影响因子：
4
作者：
Hozo SP;Djulbegovic B;Hozo I
通讯作者：
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影响因子：
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作者：
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DOI：
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发表时间：
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通讯作者：
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DOI：
10.1016/j.ijrobp.2010.04.039
发表时间：
2011-08-01
影响因子：
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作者：
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