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乳腺癌保乳术后俯卧位与仰卧位放疗危及器官剂量比较的Meta分析

高艳, 李先明, 钟鹤立, 李壮玲, 李隆兴, 李炜澔

高艳, 李先明, 钟鹤立, 李壮玲, 李隆兴, 李炜澔. 乳腺癌保乳术后俯卧位与仰卧位放疗危及器官剂量比较的Meta分析[J]. 肿瘤防治研究, 2015, 42(09): 905-910. DOI: 10.3971/j.issn.1000-8578.2015.09.010
引用本文: 高艳, 李先明, 钟鹤立, 李壮玲, 李隆兴, 李炜澔. 乳腺癌保乳术后俯卧位与仰卧位放疗危及器官剂量比较的Meta分析[J]. 肿瘤防治研究, 2015, 42(09): 905-910. DOI: 10.3971/j.issn.1000-8578.2015.09.010
GAO Yan, LI Xianming, ZHONG Heli, LI Zhuangling, LI Longxing, LI Weihao. Dosimetric Comparison Between Prone and Supine Positions in Radiotherapy on Organs at Risk after Breast-conserving Surgery: A Meta-analysis[J]. Cancer Research on Prevention and Treatment, 2015, 42(09): 905-910. DOI: 10.3971/j.issn.1000-8578.2015.09.010
Citation: GAO Yan, LI Xianming, ZHONG Heli, LI Zhuangling, LI Longxing, LI Weihao. Dosimetric Comparison Between Prone and Supine Positions in Radiotherapy on Organs at Risk after Breast-conserving Surgery: A Meta-analysis[J]. Cancer Research on Prevention and Treatment, 2015, 42(09): 905-910. DOI: 10.3971/j.issn.1000-8578.2015.09.010

乳腺癌保乳术后俯卧位与仰卧位放疗危及器官剂量比较的Meta分析

详细信息
    作者简介:

    高艳(1979-),女,硕士,主管技师,主要从事肿瘤放疗计划设计和加速器质控工作

    通讯作者:

    李先明,E-mail: lxm1828@hotmail.com

  • 中图分类号: R737.9

Dosimetric Comparison Between Prone and Supine Positions in Radiotherapy on Organs at Risk after Breast-conserving Surgery: A Meta-analysis

  • 摘要: 目的 探讨乳腺癌保乳术后采用俯卧位与仰卧位放疗危及器官的剂量差异,为临床实践提供证据。方法 制定严格的纳入和排除标准,全面检索PubMed、FMJS、CHKD和万方全文数据库。纳入乳腺癌保乳术后俯卧位与仰卧位危及器官剂量对比的相关研究。统计学处理采用Cochrane协作网提供的RevMan5.2统计软件计算标准化均差及其95%可信区间。结果 共检索到267篇文献,经评价后最终16个研究442例乳腺癌患者符合本系统评价的纳入标准。Meta分析结果显示:乳腺癌保乳术后患者采用俯卧位放疗患侧肺(SMD=-4.36,95%CI:-5.41~-3.31,P<0.001)和心脏(SMD=-0.24,95%CI:-0.4~-0.09,P<0.05)受照剂量明显低于仰卧位;对侧乳腺受照剂量在两种体位间差异无统计学意义(SMD=0.19,95%CI:-0.02~0.40,P>0.05)。结论 与仰卧位相比,乳腺癌保乳术后俯卧位放疗可明显降低心脏和患侧肺的受照剂量。

     

    Abstract: Objective To compare the dosimetric difference between prone position and supine position in breast cancer radiotherapy after breast-conserving surgery. Methods Strict inclusion and exclusion criteria were drew up. Trials were searched from PubMed, FMJS, CHKD and WanFang full-text database. Studies of the dosimetric comparisons between prone position and supine position in radiotherapy on organs at risk after breast-conserving surgery were included. Standardized mean difference and 95% confidence interval were computed by statistical software RevMan5.2 provided by the Cochrane collaboration. Results Finally, 16 trials containing 442 patients were included. The results of Meta-analysis showed that the radiation exposure of ipsilateral lung (SMD=-4.36, 95% CI: -5.41--3.31, P<0.001) and the heart (SMD=-0.24, 95%CI: -0.4--0.09, P<0.05) were dramatically lower in prone position than those in supine position, while the doses to contralateral breast did not differ between the two positions (SMD=0.19, 95%CI: -0.02~0.40, P>0.05). Conclusion Compared with supine position, prone position in breast radiotherapy is contributed to a significantly lower radiation dose for ipsilateral lung and heart of patients after breast-conserving surgery.

     

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出版历程
  • 收稿日期:  2014-09-18
  • 修回日期:  2015-03-15
  • 刊出日期:  2015-08-24

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