Efficacy and Safety in Proton Therapy and Photon Therapy for Patients With Esophageal Cancer

作者：Pixiao Zhou, Yangfeng Du, Ying Zhang, Mei Zhu, Ting Li, Wei Tian, Tao Wu, Zemin Xiao · 发表于：JAMA Network Open · 年份：2023 · DOI：10.1001/jamanetworkopen.2023.28136 · 被引用次数：34 · 研究领域：Esophageal Cancer Research and Treatment、Radiation Therapy and Dosimetry、Advanced Radiotherapy Techniques

Importance: Radiotherapy plays an important role in the treatment of esophageal cancer. Proton therapy has unique physical properties and higher relative biological effectiveness. However, whether proton therapy has greater benefit than photon therapy is still unclear. Objective: To evaluate whether proton was associated with better efficacy and safety outcomes, including dosimetric, prognosis, and toxic effects outcomes, compared with photon therapy and to evaluate the efficacy and safety of proton therapy singly. Data Sources: A systematic search of PubMed, Embase, the Cochrane Library, Web of Science, SinoMed, and China National Knowledge Infrastructure databases was conducted for articles published through November 25, 2021, and updated to March 25, 2023. Study Selection: For the comparison of proton and photon therapy, studies including dosimetric, prognosis, and associated toxic effects outcomes were included. The separate evaluation of proton therapy evaluated the same metrics. Data Extraction and Synthesis: Data on study design, individual characteristics, and outcomes were extracted. If I2 was greater than 50%, the random-effects model was selected. This meta-analysis is reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Main Outcomes and Measures: The main outcomes were organs at risk (OARs) dosimetric outcomes, prognosis (overall survival [OS], progression-free survival [PFS], and objective respon...