Abstract：
OBJECTIVE: Efforts have been made to reduce epidemiological indicators of osteoradionecrosis in patients with head and neck cancer over recent years. This umbrella review aims to synthesize the information of the systematic reviews/meta-analyses investigating the effect of radiotherapy in patients with head and neck cancer on the frequency of osteoradionecrosis and to identify and analyze the gaps in current scientific literature.
METHODS: A systematic review of systematic reviews with and without meta-analysis of intervention studies was conducted. Qualitative analysis of the reviews and their quality evaluation were performed.
RESULTS: A total of 152 articles were obtained, and ten of them were selected for the final analysis, where six were systematic reviews and four were meta-analysis. According to the guide Assessing the Methodological Quality of Systematic Reviews (Amstar), eight articles included were of high quality and two of medium quality. These descriptive systematic reviews/meta-analyses included a total of 25 randomized clinical trials, showing that radiotherapy has positive effects on the frequency of osteoradionecrosis. Even though a reduction in the incidence of osteoradionecrosis was observed back in the history, in systematic reviews with meta-analysis, overall effect estimators were not significant.
CONCLUSIONS: Differential findings are not enough to demonstrate that there is a significant reduction in the frequency of osteoradionecrosis in patients with head and neck cancer treated by radiation. Possible explanations are related to factors such as the type of studies analyzed, indicator of irradiated complication considered, and specific variables included in the analysis. Many systematic reviews did not address publication bias and did identify gaps in knowledge that require further clarification.
METHODS: A systematic review of systematic reviews with and without meta-analysis of intervention studies was conducted. Qualitative analysis of the reviews and their quality evaluation were performed.
RESULTS: A total of 152 articles were obtained, and ten of them were selected for the final analysis, where six were systematic reviews and four were meta-analysis. According to the guide Assessing the Methodological Quality of Systematic Reviews (Amstar), eight articles included were of high quality and two of medium quality. These descriptive systematic reviews/meta-analyses included a total of 25 randomized clinical trials, showing that radiotherapy has positive effects on the frequency of osteoradionecrosis. Even though a reduction in the incidence of osteoradionecrosis was observed back in the history, in systematic reviews with meta-analysis, overall effect estimators were not significant.
CONCLUSIONS: Differential findings are not enough to demonstrate that there is a significant reduction in the frequency of osteoradionecrosis in patients with head and neck cancer treated by radiation. Possible explanations are related to factors such as the type of studies analyzed, indicator of irradiated complication considered, and specific variables included in the analysis. Many systematic reviews did not address publication bias and did identify gaps in knowledge that require further clarification.
摘要：
目的：近年来在降低头颈部肿瘤患者放射性骨坏死的流行病学指标方面做出了努力。本综述旨在综合系统评价/荟萃分析的信息，调查头颈部癌症患者放疗对骨坏死频率的影响，并确定和分析当前科学文献中的空白。
方法：对有和没有干预研究荟萃分析的系统评价进行了系统综述。对评论进行定性分析及其质量评价。
结果：共获得152篇文章，其中十个被选中进行最终分析，其中6项为系统综述,4项为荟萃分析.根据评估系统审查方法质量的指南(Amstar)，其中八篇文章质量高，两篇质量中等。这些描述性系统评价/荟萃分析共包括25项随机临床试验，表明放疗对骨坏死的发生频率有积极的影响。尽管在历史中观察到放射性骨坏死的发病率降低，在具有荟萃分析的系统评价中，总体效应估计并不显著.
结论：差异研究结果不足以证明接受放射治疗的头颈部肿瘤患者放射性骨坏死的发生率显著降低。可能的解释与分析的研究类型等因素有关，考虑辐照并发症的指标，以及分析中包含的特定变量。许多系统综述没有解决出版偏见，并指出了需要进一步澄清的知识差距。
方法：对有和没有干预研究荟萃分析的系统评价进行了系统综述。对评论进行定性分析及其质量评价。
结果：共获得152篇文章，其中十个被选中进行最终分析，其中6项为系统综述,4项为荟萃分析.根据评估系统审查方法质量的指南(Amstar)，其中八篇文章质量高，两篇质量中等。这些描述性系统评价/荟萃分析共包括25项随机临床试验，表明放疗对骨坏死的发生频率有积极的影响。尽管在历史中观察到放射性骨坏死的发病率降低，在具有荟萃分析的系统评价中，总体效应估计并不显著.
结论：差异研究结果不足以证明接受放射治疗的头颈部肿瘤患者放射性骨坏死的发生率显著降低。可能的解释与分析的研究类型等因素有关，考虑辐照并发症的指标，以及分析中包含的特定变量。许多系统综述没有解决出版偏见，并指出了需要进一步澄清的知识差距。
