摘要
Abstract
Objective:To evaluate clinical efficacy and safety of the late course accelerated hyperfractionated radiotherapy(LCAH) versus conventional fraction radiotherapy for esophageal squamous cell carcinoma. Methods: PubMed, Cochrane Library, Chinese Scientific Journals full-text database, the Chinese periodical full-text databases, full-text database of digitized journals, and biomedical literature database were searched for relevant literatuers. We reviewed the references from original articles to search for more studies and tracked back to the reference to collect trails in which the deadline was Oct 2013. We included the randomized controlled trials of LCAH versus CR for esophageal squamous cell carcinoma. Two investigators assessed the quality of included trials and independently extracted data by Cochrane. The RevMan 5.1 software was used for statistical analysis. Results:A total of 12 potential relevant studies involving 1458 patients were retrieved for meta-analysis. There were significant difference between LCAH and CR in 1-year survival(OR=2.13,95%CI:1.70-2.66, P<0.00001),3-year survival rate (OR=2.28,95% CI:1.82-2.84,P<0.00001) and 5-year survival (OR=2.28,95% CI:1.79-2.91, P<0.00001) . Statistical significance were found between LCAH and CR in 1-year local control rate (OR=2.38,95%CI:1.88-3.01, P<0.00001),3-year local control rate (OR=2.83,95%CI,:2.26-3.53 P<0.00001 ) and 5 - year local control rate (OR=2.83,95% CI:2.26-3.53, P<0.00001) . Acute radiation bronchitis (OR=1.43,95% CI:1.08-1.89,P=0.01), acute radiation esophagitis incidence (OR=1.65,95% CI:1.27-2.15, P=0.0002) in LCAH was significantly higher than CR for side effect of acute radiation, but the opposite was true for local recurrence rate(OR=0.49,95%CI:0.38-0.63,P<0.00001). There were no significant difference between LCAH and CR in treatment failure rate (local recurrence and distant metastasis:OR=0.93,95% CI:0.65-1.31,P=0.66). Conclusions: Compared to CR, LCAH could improve 1-year survival rate, 3-year survival rate and 5-year survival rates, local control rates, the incidence of acute radiation bronchitis and esophagitis and reduce local recurrence;meanwhile it isn' t reduce the incidence of distance metastasis. Large and well designed multicenter randomized controlled trial will be necessary to validate clinical efficacy and safety of LCAH versus conventional fraction radiotherapy for esophageal squamous cell carcinoma.关键词
食管癌/放射治疗/后程加速超分割放疗Key words
esophageal cancer/radiotherapy/late course accelerated hyperfractionated/conventional radiation therapy
