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中国癌症防治杂志

中国癌症防治杂志 ›› 2025, Vol. 17 ›› Issue (3): 358-365.doi: 10.3969/j.issn.1674-5671.2025.03.14

• 头颈部肿瘤专栏 • 上一篇    下一篇

质子放疗与光子放疗在头颈部肿瘤治疗中的疗效及安全性比较：一项系统回顾和Meta分析#br#

  

  1. 广西医科大学附属肿瘤医院放射肿瘤科
  • 出版日期:2025-06-25 发布日期:2025-07-10
  • 通讯作者: 苏庭世 E-mail:sutingshi@163.com

A systematic review and Meta?analysis comparing the efficacy and safety of proton therapy versus X?ray radiation therapy in the treatment of head and neck cancer

  • Online:2025-06-25 Published:2025-07-10

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摘要： 目的 比较质子放疗（proton therapy,PT）和光子放疗（X⁃ray radiation therapy,XRT）在头颈部肿瘤中的疗效与安全性。方法 通过系统回顾和荟萃分析，纳入了2015年至2024年期间发表的13项研究，其中PT组863例，XRT组2 443例。分析评估了1年和2年的局部控制（local control,LC）率，1年、2年和3年的总生存（overall survival,OS）率以及无病生存/进展生存（disease⁃free survival and progression⁃free survival, DFS/PFS）率。此外，还分析了2级或以上急性毒性的发生率。结果 在1年LC率方面，PT组与XRT组之间无显著差异（RR=1.16，95%CI:0.19~7.25），2年LC率也没有显著差异（RR=0.74, 95%CI:0.54~1.02）；此外，在1年（RR=0.93,95%CI:0.67~1.29）、2年（RR=0.91, 95%CI:0.67~1.22）和3年（RR=0.99, 95%CI:0.75~1.29）DFS/PFS率方面，两组比较均无显著差异。然而，PT组在1年（RR=0.47, 95%CI: 0.35~0.65）、2年（RR=0.52,95%CI:0.40~0.67）和3年的OS（RR=0.56,95%CI:0.45~0.69）均优于XRT组。此外，PT组中≥2级吞咽困难（OR=0.35, 95%CI:0.18~0.69）和疲乏（OR=0.46,95%CI:0.24~0.90）的发生率均低于XRT组。结论 在头颈部癌症治疗中，PT显示出比XRT更优的总生存获益和更低的急性毒性风险。未来需更多前瞻性研究验证PT的有效性和安全性。

关键词: 头颈部肿瘤, 质子放疗, 光子放疗, 生存率, 毒性

Abstract: Objective To systematically evaluate and compare the efficacy and safety profiles of proton therapy (PT)  and X⁃ray radiation therapy (XRT)  in head and neck cancer. Methods  A systematic review and meta⁃analysis were conducted, incorporating thirteen studies published between 2015 and 2024, comprising 863 cases in the PT group and 2，443 cases in the XRT group. The analysis evaluated local control (LC) rate at 1 and 2 years, disease⁃free survival/progression⁃free survival (DFS/PFS) rate at 1, 2, and 3 years,  as well as overall survival (OS) rate. Additionally, it examined the incidence of acute toxicities of grade 2 or higher. Results No statistically significant differences were observed between the PT group and the XRT group in terms of 1⁃year LC rate  OR=1.16, 95%CI: 0.19-7.25) or 2⁃year LC rate (RR=0.74, 95%CI: 0.54-1.02). Furthermore , there were no statistically significant differences in DFS/PFS rate between the two groups at 1⁃year (RR=0.93, 95%CI: 0.67-1.29), 2⁃year (RR=0.91, 95%CI: 0.67-1.22), and 3⁃year (RR=0.99, 95%CI: 0.75-1.29). However, the PT group demonstrated superior OS at 1⁃year (CI=0.47, 95%CI: 0.35-0.65), 2⁃year (RR=0.52, 95%CI: 0.40-0.67), and 3⁃year (RR=0.56, 95%CI: 0.45-0.69) compared to the XRT group. Additionally, the incidence of  ≥grade 2 dysphagia (OR=0.35, 95%CI: 0.18-0.69) and fatigue (OR=0.46, 95%CI: 0.24-0.90) was lower in the PT group than in the XRT group. Conclusions The PT group demonstrates superior survival benefits and reduced acute toxicity risks compared to the XRT group in the treatment of head and neck cancer. Further prospective studies are warranted to validate the efficacy and safety of PT.

Key words: Head and neck cancer, Proton therapy, X?ray radiation therapy, Survival ratio； Toxicity

中图分类号: 

  • R739.91