背景:放射性皮炎(RD)是放射治疗(RT)的普遍且难以控制的后果。各种干预措施已被证明可有效预防和治疗RD。然而,最佳方法尚不清楚。该网络荟萃分析(NMA)对目前在RD中使用的干预措施的有效性和患者报告结果(PRO)进行了比较和排名。
方法:PubMed,WebofScience,Embase,和Cochrane图书馆进行检索,以确定相关的随机对照试验(RCTs),重点关注RD的预防和治疗.主要结果指标包括≥2级RD的发生率(即,潮湿脱屑的百分比)和RD评分。次要结果指标包括患者疼痛的主观评估评分,瘙痒和灼热的感觉。
结果:我们的荟萃分析包括42项研究和4884名参与者。关于主要结果,光生物调节治疗(PBMT)在曲线下的表面累积排序面积(SUCRA:0.92)中排名第一,以减少≥2级RD的发生率。与Trolamine(OR0.18,95%CrI0.09-0.33)和Xonrid®(OR0.28,95%CrI0.12-0.66)相比,它显示出显着差异。Mepitelfilm(SUCRA:0.98)在降低RD得分方面排名最高,显示优于StrataXRT®(MD-0.89,95%CrI-1.49,-0.29)。指甲花(SUCRA:0.89)在提供疼痛缓解方面表现出最高的效果,与Hydrofilm(MD-0.44,95%CrI-0.84,-0.04)和Mepitelfilm(MD-0.55,95%CrI-0.91,-0.19)相比具有显着差异。水膜(SUCRA:0.84)表现出最少的瘙痒感,显示优于Mepitelfilm(MD-0.50,95%CrI-0.84,-0.17)。在评估灼烧感的各种干预措施中,没有观察到统计学上的显着差异。
结论:PBMT和Mepitelfilm在降低≥2级RD和RD评分的发生率方面表现出更好的疗效,分别。在Pro方面,指甲花和水膜对疼痛和瘙痒的抱怨较少,分别。然而,未来有必要对不同干预措施进行更大样本量的研究.
背景:PROSPERO注册号CRD42023428598。
BACKGROUND: Radiation dermatitis (RD) is a prevalent and difficult-to-manage consequence of radiation therapy (RT). A variety of interventions have been proven effective in preventing and treating RD. However, the optimal approach remains unclear. This network meta-analysis (NMA) conducted a comparison and ranking of the effectiveness and patient-reported outcomes (PROs) of the interventions currently utilized in RD.
METHODS: PubMed, Web of Science, Embase, and Cochrane Library were searched to identify pertinent randomized controlled trials (RCTs) focused on the prevention and treatment of RD. The primary outcome measures included the incidence of grade≥2 RD (i.e., percentage of moist desquamation) and RD score. The secondary outcome measures encompassed patients\' subjective assessment scores of pains, itching and burning sensations.
RESULTS: Our meta-analysis encompassed 42 studies and 4884 participants. Regarding the primary outcomes, photobiomodulation treatment (PBMT) ranked first in surface under curve cumulative ranking area (SUCRA:0.92) for reducing the incidence of grade≥2 RD. It demonstrated a significant difference when compared to Trolamine (OR 0.18,95%CrI 0.09-0.33) and Xonrid® (OR 0.28,95%CrI 0.12-0.66). Mepitelfilm (SUCRA: 0.98) achieved the highest rank in reducing the RD score, demonstrating superiority over StrataXRT® (MD -0.89, 95% CrI -1.49, -0.29). Henna (SUCRA: 0.89) demonstrated the highest effectiveness in providing pain relief, with a significant difference compared to Hydrofilm (MD -0.44, 95% CrI -0.84, -0.04) and Mepitelfilm (MD -0.55, 95% CrI -0.91, -0.19). Hydrofilm (SUCRA: 0.84) exhibited the fewest itching sensations, demonstrating superiority over Mepitelfilm (MD -0.50, 95% CrI -0.84, -0.17). No statistically significant difference was observed among various interventions in the assessment of burning sensations.
CONCLUSIONS: PBMT and Mepitelfilm demonstrated better efficacy in reducing the incidence of grade≥2 RD and RD score, respectively. In terms of PROs, Henna and Hydrofilm had fewer complaints in pain and itching sensations, respectively. However, studies with larger sample size on different interventions are warranted in the future.
BACKGROUND: PROSPERO registration number CRD42023428598.