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重离子放射系统治疗肿瘤的快速卫生技术评估

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目的 对重离子放射治疗的安全有效性和经济性开展评估,为科学合理开展设备配置提供参考.方法 采用快速卫生技术评估方法,使用PICOS工具在国际HTA机构数据库以及CBM、CNKI、PubMed等中英文期刊文献数据库中检索与重离子放射治疗系统安全有效性、经济性研究有关的文献,采用AMSTAR2和CHEERS量表对纳入的文献开展质量评价并进行归纳分析.结果 截至2023年7月,全球约有13家运行中的重离子放射治疗中心.纳入重离子放射治疗系统安全有效性相关文献共10篇,通过中等质量证据显示对比传统光子放疗和质子治疗,现有证据不足以说明重离子放疗在头颈部肿瘤、鼻腔/鼻旁窦肿瘤、腺样囊性涎腺癌、非小细胞肺癌以及前列腺癌患者中的效果优劣.纳入经济性研究相关文献共5篇,较高质量证据显示对于不可手术非小细胞肺癌,重离子放疗和立体定向放疗都优于质子放疗和传统放疗(成本更低、效果更好).结论 目前关于重离子放疗的安全有效性和经济性研究仍然有限,且鲜有国内的重离子放疗经济性相关研究,未来探索的关键是更深入的研究和多中心的随机试验,以推动该技术的持续进步和广泛应用.
Rapid Health Technology Assessment of Heavy-Ion Radiation System for Tumor Treatment
Objective To evaluate the safety,effectiveness and economic study of heavy-ion radiotherapy,and to provide reference for scientific and rational equipment allocation.Methods The rapid health technology assessment method was used to search the international HTA database,CBM,CNKI,PubMed and other Chinese and English journal literature databases by PICOS.AMSTAR2 and CHEERS were used to quality assessment and inductive analysis of the included literature.Results As of July 2023,there were approximately 13 active heavy ion radiotherapy centers worldwide.A total of 10 literature related to the safety and effectiveness of heavy-ion radiotherapy system was searched and included in this study.The medium-quality evidence showed that compared with traditional photon radiotherapy and proton therapy,the existing evidence was insufficient to demonstrate the advantages and disadvantages of heavy ion radiotherapy in patients with head and neck tumors,nasal/sinus tumors,adenoid cystic salivary gland carcinoma,non-small cell lung cancer and prostate cancer.A total of 5 literature related to economic study was included in the search,and high quality evidence showed that heavy ion radiotherapy and stereotactic radiotherapy were superior to proton radiotherapy and traditional radiotherapy for non-operable non-small cell lung cancer.Conclusion At present,there are limited studies on the cost-effectiveness of heavy ion radiotherapy,and there is a lack of local economic study in China.The key to future exploration is more in-depth research and multi-center randomized trials to promote the continuous progress and wide application of this technology.

heavy-ion radiation systemrapid health technology assessmentsafety and effectiveness evaluationeconomic evaluation

张晨、葛悦、魏艳、田丹、杨毅、陈英耀

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上海交通大学医学院附属上海儿童医学中心 保障运维部,上海 200127

复旦大学 公共卫生学院 国家卫生健康委员会卫生技术评估重点实验室,上海 200032

重离子放射系统 快速卫生技术评估 安全有效性评估 经济性评估

国家重点研发计划

2016YFC0106900

2024

中国医疗设备
中国整形美容协会

中国医疗设备

CSTPCD
影响因子:0.825
ISSN:1674-1633
年,卷(期):2024.39(4)
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