| Objective To comprehensively analyze radiotherapy technique,curative effect and nutritional intervention,for evaluating the safety of radiotherapy and effect of nutritional intervention for nasopharyngeal carcinoma(NPC)by means of literature metrology and Meta analysis.To provide the basis for prevention of radiotherapy injury and strategy of nutrition prevention and treatment in the clinical.Contents and methods(1)Analyzing the frontier and focus of radiotherapy related research on nasopharyngeal carcinoma by the method of literature metrology.CNKI,Wanfang,Weipu and Medline were used to search the literatures of nasopharyngeal carcinoma radiotherapy from January 2006 to December 2016.It?s counted to technique of radiation therapy,ray of radiation therapy,regional distribution of nasopharyngeal carcinoma and radioside reaction,and other information by SPSS software.(2)The efficacy and safety of three dimensional conformal radiotherapy in the treatment of nasopharyngeal carcinoma were systematically evaluated by Meta analysis.Searching and collecting Chinese and English relevant literatures for articles published from CNKI,Wanfang,Weipu,Webof science,Embase,Science direct,Medline,Cochrane Library database inception to December,2016.The software of Revman 5.3was used to analyze statistically.The heterogeneity is evaluated by Cochrane's Q test and I2 statistics among studies.Funnel map made by Revman was used to evaluate publication bias.(3)The effect of nutritional intervention on patients with nasopharyngeal carcinoma radiotherapy was systematically evaluated by Meta analysis.Searching Chinese and English relevant literatures for articles published from the time of establishment of CNKI,Wanfang,Weipu,Web of science,Embase,Science direct,Medline,Cochrane Library database to January,2018.The software of Revman 5.3 was used to analyze statistically.The heterogeneity is evaluated by Cochrane's Q test and I2 statistics among studies.Funnel map made by Revman was used to evaluate publication bias.Result(1)From January 2006 to December 2016,the study of radiotherapy in nasopharyngeal carcinoma in China was stable and mature.A total of 779 articles were published in 607 journals about the nasopharyngeal carcinoma radiotherapy.The journal of the largest publication number is the modern tumor medical journal,and the research institutions of the largest publication number is Sun Yat-sen University.The study of Intensity modulated radiation therapy(IMRT)is the most among nasopharyngeal carcinoma radiotherapy technique.(2)Ten RCTs including 481 cases in the test group(three-dimensional radiotherapy)and 505 cases in the control group(conventional radiotherapy)were included.The results of the test group showed that the 1-year survival rate[RD=0.15,95%CI(0.11,0.19),Z=6.86,P<0.05],2-year survival rate[RD=0.09,95%CI(0.03,0.15),Z=2.84,P<0.05],3-year survival rate[RD=0.15,95%CI(0.09,0.20),Z=5.30,P<0.05],1 year localcontrol rate [RD=0.19,95%CI(0.12,0.27),Z=5.09,P<0.05],3 year localcontrol rate [RD=0.18,95%CI(0.10,0.26),Z=4.50,P<0.05]were higher than those of the control group,the difference is significant statistically.The test group has a significant reduction in radioactive difficulty in opening mouth[RD=?0.17,95%CI(?0.26,?0.09),Z=4.09,P<0.05].(3)11 RCTs including 443 cases in nutrition intervention group and 391 cases in the control group were included.The results showed that the body weight [MD=6.80,95%CI(5.67,7.93),Z=11.80,P<0.00001],hemoglobin [MD=2.22,95%CI(1.59,2.85),Z=6.88,P<0.00001],albumin [MD=2.97,95%CI(1.57,4.38),Z=4.14,P<0.00001] and the incidence of oropharyngeal mucositis[OR=0.25,95%CI(0.17,0.36),Z=7.20,P<0.00001] of the test group were higher than those of the control group,the difference is significant statistically.while there was no significant difference in the incidence of nutritional risk(NRS2002?3)[OR=0.38,95%CI(0.12,1.15),Z=1.93,P=0.09] between the nutritional intervention group and the control group after radiotherapy.Conclusion(1)The study of nasopharyngeal carcinoma radiotherapy is becoming more and more stable in China,and it is an important study future of the best radiotherapy method of NPC.(2)Compared with conventional radiotherapy,three-dimensionalconformal radiotherapy can improve the survival rate and local control rate of patients,and reduce the risk of radioactive difficulty in opening mouth.(3)Compared with the control group,nutritional support could improve the nutritional index of nasopharyngeal carcinoma(NPC)patients with radiotherapy,and depress the risk of oropharyngeal mucosal injury(grade 3-4).While the effect of nutritional intervention on the occurrence of nutritional risk needs to be further verified. |
PDF Full Text Request