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摘要:目的
了解宫颈癌组织间插植放疗的研究现状，对比分析国内外不同插植模式的应用。
方法检索PubMed、EMBASE、Web of Science、Cochrane Library（2015年12期）、中国生物医学文献数据库（CBM）、中国知网（CNKI）和万方数据库，检索时间均为建库至2015年12月31日。全面收集有关宫颈癌组织间插植近距离放疗的临床研究，由两名评价员分别进行文献筛选，并按照预先设计的资料提取表进行资料提取。
结果共纳入85篇研究，英文35篇，中文50篇，其中24.7%（21/85）研究为临床对照研究。英文研究第一作者国家主要集中在美国（13/35）和印度（6/35），而中文研究主要分布于广州（10/50）和江苏（7/50）。中文文献来自43种期刊，仅18%（9/50）被中国科学引文数据库（CSCD）收录。随访时间、插植相关特征、治疗引导方式等报告率较低。大多研究（60/68）采用高剂量率（high dose rate, HDR）近距离治疗，采用的插植模式多达11种。32%（8/25）英文文献采用单次剂量5.5~6 Gy，每天两次，5~6次，均为会阴模板全麻下插植，而53.1%（17/32）的中文文献采用单次剂量8~12 Gy，每周1次，1~3次，均为徒手插植。
结论宫颈癌组织间插植放疗研究的临床特征报告率较低，尤其是中文文献，同时对照研究数量较少。中英文研究组织间插植模式多样，无论是插植剂量，还是插植模板、麻醉方式均存在明显的差异。
Abstract:ObjectiveTo analysis the status of interstitial brachytherapy(ISBT) treatment of cervical cancer and compare the application of different ISBT modes.
MethodsThe databases of PubMed, EMBASE, Web of Science, Cochrane Library(2015. Issue12), Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI) and Wanfang were searched from the starting to December 31st, 2015. The clinical studies on ISBT were comprehensively collected. Articles were screened by two reviewers and the process of extraction was done by pre-designed table including general characteristic and radiation-related clinical features.
ResultsA total of 85 studies were included, 35 in English and 50 in Chinese. 24.7%(21/85) were clinical controlled studies. The first authors in English studies were mainly from America (13/35) and India (6/35), while those in the Chinese articles were mainly from Guangzhou (10/50) and Jiangsu(7/50) of China. Chinese articles were from 43 journals and only 18.0%(9/50) were included by CSCD. The reporting of follow-up time, feature of ISBT and treatment guided methods was incomplete. Most studies (60/68) used high dose rate (HDR) brachytherapy, and 11 modes were applied. The mode of 5.5-6Gy per fraction and 5-6 fractions twice a day were used by transperineal ISBT in 32%(8/25) of English studies, but 53.1%(17/32) of Chinese studies used 6-12Gy per fraction and 1-3 fractions weekly by barehanded ISBT.
ConclusionThe reporting of ISBT on cervical cancer is still incomplete, especially in Chinese studies. The number of controlled trial is small. The modes of ISBT are various and non-standard. It has significant differences in ISBT dose, template and anesthesia.
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Key words:
- Cervical cancer /
- Interstitial brachytherapy /
- Brachytherapy /
- Status analysis
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图 2 英文研究第一作者国家分布
Figure 2 Distribution of the first authors' country in English studies
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图 3 中文研究第一作者地区分布
Figure 3 Distribution of the first authors' province in Chinese studies
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