{"title":"粒子束治疗在肝外胆道癌中的作用光子与粒子放疗比较的最新系统综述和荟萃分析。","authors":"Hideya Yamazaki, Takuya Kimoto, Satoshi Teramukai, Mitsuko Nakata, Kei Shibuya, Motohisa Suzuki, Kazuki Terashima, Takashi Iizumi, Masaru Wakatsuki, Takayuki Hashimoto, Takumi Fukumoto, Masayuki Ohtsuka","doi":"10.1002/jhbp.12156","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/purpose: </strong>The study was designed to examine the role of particle beam therapy (PT) in the treatment of extrahepatic biliary cancer (EHC).</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis to compare the outcomes of PT and photon radiotherapy in treating EHC. Medline/PubMed and Japan Medical Abstracts databases were screened using a systematic search strategy. The primary endpoint was overall survival (OS), pooled using a random effects model.</p><p><strong>Results: </strong>In total, 236 articles were retrieved. After screening, 11 articles were retained, comprising 2108 patients (nine photon articles, n = 2038 patients; two PT articles, n = 70 patients). We have updated and incorporated the outcomes of the prospective data registry (Proton-net, n = 137 patients) for PT. The 1-year OS probability rates were 56% (95% confidence interval = 49%-62%) for the photon and 72% (65%-78%) for the PT groups (p < 0.001). The median survival time was 13.1 months (11.0-15.1 months) for the photon group and 18.8 months (14.1-23.4 months) for the PT group (p = 0.03). The PT group demonstrated a superior OS rate compared to that observed in the photon group. The incidence rates of grade 3 ≤ toxicity was 18.5%-33% in the photon radiotherapy group and 2.9%-15% in the PT group.</p><p><strong>Conclusion: </strong>PT demonstrated superior outcomes with acceptable toxicity compared to those noted with photon radiotherapy for EHC in this meta-analysis. In the absence of randomized trials, this meta-analysis provides useful evidence that PT can be considered an effective therapeutic modality for EHC.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Role of Particle Beam Therapy for Extrahepatic Biliary Cancer-Updated Systematic Review and Meta-Analysis for Comparison Between Photon and Particle Radiotherapy.\",\"authors\":\"Hideya Yamazaki, Takuya Kimoto, Satoshi Teramukai, Mitsuko Nakata, Kei Shibuya, Motohisa Suzuki, Kazuki Terashima, Takashi Iizumi, Masaru Wakatsuki, Takayuki Hashimoto, Takumi Fukumoto, Masayuki Ohtsuka\",\"doi\":\"10.1002/jhbp.12156\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/purpose: </strong>The study was designed to examine the role of particle beam therapy (PT) in the treatment of extrahepatic biliary cancer (EHC).</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis to compare the outcomes of PT and photon radiotherapy in treating EHC. Medline/PubMed and Japan Medical Abstracts databases were screened using a systematic search strategy. The primary endpoint was overall survival (OS), pooled using a random effects model.</p><p><strong>Results: </strong>In total, 236 articles were retrieved. After screening, 11 articles were retained, comprising 2108 patients (nine photon articles, n = 2038 patients; two PT articles, n = 70 patients). We have updated and incorporated the outcomes of the prospective data registry (Proton-net, n = 137 patients) for PT. The 1-year OS probability rates were 56% (95% confidence interval = 49%-62%) for the photon and 72% (65%-78%) for the PT groups (p < 0.001). The median survival time was 13.1 months (11.0-15.1 months) for the photon group and 18.8 months (14.1-23.4 months) for the PT group (p = 0.03). The PT group demonstrated a superior OS rate compared to that observed in the photon group. The incidence rates of grade 3 ≤ toxicity was 18.5%-33% in the photon radiotherapy group and 2.9%-15% in the PT group.</p><p><strong>Conclusion: </strong>PT demonstrated superior outcomes with acceptable toxicity compared to those noted with photon radiotherapy for EHC in this meta-analysis. In the absence of randomized trials, this meta-analysis provides useful evidence that PT can be considered an effective therapeutic modality for EHC.</p>\",\"PeriodicalId\":16056,\"journal\":{\"name\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-05-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hepato‐Biliary‐Pancreatic Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jhbp.12156\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hepato‐Biliary‐Pancreatic Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jhbp.12156","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景/目的：本研究旨在探讨粒子束治疗（PT）在肝外胆道癌（EHC）治疗中的作用。方法：我们进行了系统回顾和荟萃分析，比较PT和光子放疗治疗EHC的结果。使用系统搜索策略筛选Medline/PubMed和Japan Medical Abstracts数据库。主要终点是总生存期（OS），采用随机效应模型汇总。结果：共检索到236篇文献。筛选后，保留11篇文章，共2108例患者(9篇光子文章，n = 2038例患者；两篇PT文章，n = 70例患者)。我们更新并纳入了前瞻性数据注册表（Proton-net, n = 137例患者）的结果。光子组的1年OS概率为56%(95%置信区间= 49%-62%)，PT组的1年OS概率为72% (65%-78%)(p结论：在本荟萃分析中，与光子放射治疗EHC相比，PT显示出更好的结果和可接受的毒性。在缺乏随机试验的情况下，本荟萃分析提供了有用的证据，证明PT可以被认为是EHC的有效治疗方式。
Role of Particle Beam Therapy for Extrahepatic Biliary Cancer-Updated Systematic Review and Meta-Analysis for Comparison Between Photon and Particle Radiotherapy.
Background/purpose: The study was designed to examine the role of particle beam therapy (PT) in the treatment of extrahepatic biliary cancer (EHC).
Methods: We conducted a systematic review and meta-analysis to compare the outcomes of PT and photon radiotherapy in treating EHC. Medline/PubMed and Japan Medical Abstracts databases were screened using a systematic search strategy. The primary endpoint was overall survival (OS), pooled using a random effects model.
Results: In total, 236 articles were retrieved. After screening, 11 articles were retained, comprising 2108 patients (nine photon articles, n = 2038 patients; two PT articles, n = 70 patients). We have updated and incorporated the outcomes of the prospective data registry (Proton-net, n = 137 patients) for PT. The 1-year OS probability rates were 56% (95% confidence interval = 49%-62%) for the photon and 72% (65%-78%) for the PT groups (p < 0.001). The median survival time was 13.1 months (11.0-15.1 months) for the photon group and 18.8 months (14.1-23.4 months) for the PT group (p = 0.03). The PT group demonstrated a superior OS rate compared to that observed in the photon group. The incidence rates of grade 3 ≤ toxicity was 18.5%-33% in the photon radiotherapy group and 2.9%-15% in the PT group.
Conclusion: PT demonstrated superior outcomes with acceptable toxicity compared to those noted with photon radiotherapy for EHC in this meta-analysis. In the absence of randomized trials, this meta-analysis provides useful evidence that PT can be considered an effective therapeutic modality for EHC.
期刊介绍：
The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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