立体定向放射治疗作为宫颈癌近距离治疗的替代方法（SCORE）：一项系统综述和荟萃分析

IF 5.5 2区医学 Q1 HEMATOLOGY

Critical reviews in oncology/hematology Pub Date : 2025-06-01 DOI:10.1016/j.critrevonc.2025.104789

Jessé Lopes da Silva , Ana Verena Silvany Sampaio de Miranda , Gustavo Viani Arruda , Diocésio Alves Pinto de Andrade , Larissa Müller Gomes , Marcela Bonalumi dos Santos , Kleyton Santos de Medeiros , Andréia Cristina de Melo

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引用次数: 0

摘要

目的：本研究评估立体定向体放疗（SBRT）作为近距离放疗（BCT）替代局部晚期宫颈癌（CC）患者的有效性和安全性，这些患者面临资源限制、解剖学挑战或合共病等障碍，无法进行标准治疗。方法采用系统回顾和荟萃分析，在PROSPERO注册并遵循PRISMA标准，评估SBRT替代BCT治疗CC的效果。符合条件的研究系统地从PubMed、Embase和Cochrane数据库中检索。采用随机效应模型解决研究异质性。分析的重点是局部对照（LC）、晚期胃肠道（GI）和泌尿生殖系统（GU）毒性和总生存率（OS），并通过meta回归探索治疗变量与结果之间的相关性。该综述分析了2012年至2024年不同地区的13项研究，参与者年龄从52岁到80岁不等，样本量从6到55名患者不等。合并LC率为94 %(95 % CI: 91 ~ 97 %)，OS率为56 %(95 % CI: 48 ~ 63 %)，无异质性。晚期≥ 3 GI和GU毒性均为2 %。meta回归分析发现治疗参数与分析结果之间无显著关联。结论sbrt对不能行BCT的CC患者是一种可行的增强治疗方法。它显示出强烈的LC和低水平的严重晚期毒性。需要进一步的前瞻性随机试验来完善SBRT方案并确认长期结果。

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Stereotactic body radiotherapy as an alternative to brachytherapy in cervical cancer (SCORE): A systematic review and meta-analysis

Objective

This study evaluates the efficacy and safety of Stereotactic Body Radiotherapy (SBRT) as an alternative to brachytherapy (BCT) for patients with locally advanced cervical cancer (CC) who face barriers such as resource constraints, anatomical challenges, or comorbidities precluding standard treatment.

Methods

A systematic review and meta-analysis, registered with PROSPERO and adhered to PRISMA standards, was conducted to evaluate SBRT in place of BCT for CC treatment. Eligible studies were systematically sourced from PubMed, Embase, and Cochrane databases. A random-effects model was applied to address study heterogeneity. The analysis focused on outcomes including local control (LC), late gastrointestinal (GI) and genitourinary (GU) toxicity, and overall survival (OS) rates with meta-regression exploring correlations between treatment variables and outcomes.

Results

The review analyzed thirteen studies from 2012 to 2024 across diverse regions, with participant ages ranging from 52 to 80 years and sample sizes from 6 to 55 patients. The combined LC rate was 94 % (95 % CI: 91–97 %), and the OS rate was 56 % (95 % CI: 48–63 %), showing no heterogeneity. Late grade ≥ 3 GI and GU toxicity were both 2 %. Meta-regression analysis found no significant associations between treatment parameters and the analyzed outcomes.

Conclusion

SBRT is a viable boost therapy for CC patients unable to undergo BCT. It demonstrates strong LC and low levels of severe late toxicity. Further prospective randomized trials are necessary to refine SBRT protocols and confirm long-term outcomes.

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来源期刊

Critical reviews in oncology/hematology 医学-血液学

CiteScore

11.00

自引率

3.20%

发文量

213

审稿时长

55 days

期刊介绍： Critical Reviews in Oncology/Hematology publishes scholarly, critical reviews in all fields of oncology and hematology written by experts from around the world. Critical Reviews in Oncology/Hematology is the Official Journal of the European School of Oncology (ESO) and the International Society of Liquid Biopsy.