PDF(Pubmed)
Abstract：
The aim of this study was to investigate the efficacy and safety of particle beam therapy (PBT) with proton or carbon ion beam for pelvic recurrence of colorectal cancer (PRCC) by comparing the clinical outcomes of a dataset of prospectively enrolled patients for PBT with those from the literature, which were collected by a systematic review of external X-ray radiotherapy (XRT) and PBT. Patients with PRCC treated at 14 domestic facilities between May 2016 and June 2019 and entered the database for prospective observational follow-up were analyzed. The registry data analyzed included 159 PRCC patients treated with PBT of whom 126 (79%) were treated with carbon ion radiation therapy (CIRT). The 3-year overall survival and local control rate were 81.8 and 76.4%, respectively. Among these PRCC patients, 5.7% had Grade 3 or higher toxicity. Systematic search of PubMed and Cochrane databases published from January 2000 to September 2020 resulted in 409 abstracts for the primary selection. Twelve studies fulfilled the inclusion criteria. With one additional publication, 13 studies were selected for qualitative analysis, including 9 on XRT and 4 on PBT. There were nine XRT studies, which included six on 3D conformal radiotherapy and three on stereotactic body radiation therapy, and four PBT studies included three on CIRT and one on proton therapy. A pilot meta-analysis using literatures with median survival time extractable over a 20-month observation period suggested that PBT, especially CIRT, may be a promising treatment option for PRCC not amenable to curative resection.
摘要：
这项研究的目的是通过比较前瞻性纳入PBT患者数据集的临床结果，研究质子或碳离子束的粒子束疗法（PBT）治疗结直肠癌盆腔复发（PRCC）的疗效和安全性。通过系统评价体外X线放疗（XRT）和PBT收集。分析了2016年5月至2019年6月期间在14家国内机构接受PRCC治疗并进入数据库进行前瞻性观察性随访的患者。分析的登记数据包括159名接受PBT治疗的PRCC患者，其中126名（79％）接受了碳离子放射疗法（CIRT）治疗。3年总生存率和局部控制率分别为81.8%和76.4%,分别。在这些PRCC患者中，5.7%具有3级或更高的毒性。2000年1月至2020年9月发布的PubMed和Cochrane数据库的系统搜索结果为主要选择提供了409份摘要。12项研究符合纳入标准。加上一份额外的出版物，选择了13项研究进行定性分析，包括XRT上的9和PBT上的4。有九项XRT研究，其中包括六个3D适形放射治疗和三个立体定向放射治疗，四项PBT研究包括三项关于CIRT的研究和一项关于质子治疗的研究。一项使用20个月观察期内中位生存时间可提取文献的试点荟萃分析显示，PBT，尤其是CIRT,对于不适合根治性切除的PRCC，可能是一种有希望的治疗选择。
