质子射线与光子射线治疗肺癌的剂量学比较：meta分析

BACKGROUND AND OBJECTIVE: The clinical evidences are not sufficient on the proton beam therapy of lung cancer for lacking of the RCTs on the comparing the proton with the photon beam in lung cancer radiotherapy. The aim of this study is to evaluate the dosimetry superiority of the proton beam and provide more valuable evidences to the clinical researches. METHODS: Clinical trails of dosimetric comparing between protons beam and photons beam for lung cancer radiotherapy were obtained from the Cochrane library, Pubmed, EMbase, CBM, CNKI, VIP, and Wan Fang databases. The data included in the study were evaluated and analyzed using the Cochrane Collaboration's RevMan 5.2 software. RESULTS: Six trails were included. Compared to photon therapy (three-dimensional conformal photon radiotherapy, 3D-CRT), the proton therapy had a significantly lower total lung D(mean) (MD=-4.15, 95%CI: -5.56--2.74, P < 0.001) and V20, V10, V5 (MD=-10.92, 95%CI: -13.23--8.62, P < 0.001); The V20, V10, V5 significantly decreased in proton therapy group. Compared to photon therapy (intensity-modulated photon radiotherapy, IMRT), V20, V10, V5 were also significantly lowered in proton therapy group (MD=-3.70, 95%CI: -5.31--2.10, P < 0.001; MD=-8.86, 95%CI: -10.74--6.98, P < 0.001; MD=-20.13, 95%CI: -27.11--13.14, P < 0.001); The esophagus D(mean) was not lowered, while the heart D(mean) decreased in proton therapy group. CONCLUSION: Comparing to photon beam radiotherapy (3D-CRT and IMRT), proton beam therapy is advantageous in dosimetry of the lung cancer radiotherapy and recommended for clinical applying.