Personalizing Prophylactic Radiotherapy for Hip Heterotopic Ossification: An AMSTAR-2 Compliant Review of Meta-analyses.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL In vivo Pub Date : 2024-07-01 DOI:10.21873/invivo.13603

Erika Galietta, Luca Gaiani, Claudio Giannini, Andrea Sambri, Milly Buwenge, Gabriella Macchia, Francesco Deodato, Savino Cilla, Lidia Strigari, Alessandra Arcelli, Michele Fiore, Silvia Cammelli, Massimiliano DE Paolis, Alessio Giuseppe Morganti

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Abstract

Background/aim: Heterotopic ossification (HO) is a common complication following total hip arthroplasty. Various prophylactic treatments have been proposed, including radiotherapy (RT). This review summarizes the evidence from meta-analyses on the efficacy of RT in preventing hip HO.

Materials and methods: A literature search was conducted on PubMed. The quality of the meta-analyses was assessed using the AMSTAR-2 tool.

Results: Seven meta-analyses were included. One meta-analysis reported a significant reduction in HO occurrence after RT compared to the control group. Comparing RT and non-steroidal anti-inflammatory drugs, one and two meta-analyses showed significantly greater efficacy of RT in preventing severe HO and better outcomes in patients receiving drugs, respectively. Regarding RT settings, the postoperative and preoperative RT were each supported by one meta-analysis. Furthermore, two meta-analyses showed an advantage of multi-fractionated RT over single fraction RT. The overall confidence rate of the meta-analyses was moderate, low, and critically low in one, three, and three meta-analyses, respectively.

Conclusion: RT is a confirmed prophylactic intervention for HO. However, the precise optimization of timing, dosage, and fractionation requires elucidation. Future research should focus on the development of predictive models through large-scale data collection and advanced analytics to refine individualized treatment strategies and assess RT comparative effectiveness with drugs.

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髋关节异位骨化的个性化预防性放疗：符合 AMSTAR-2 标准的 Meta 分析综述。

背景/目的：异位骨化（HO）是全髋关节置换术后常见的并发症。目前已提出多种预防性治疗方法，包括放射治疗（RT）。本综述总结了RT在预防髋关节骨化方面疗效的荟萃分析证据：在 PubMed 上进行了文献检索。采用AMSTAR-2工具评估荟萃分析的质量：结果：共纳入七项荟萃分析。其中一项荟萃分析表明，与对照组相比，RT 治疗后 HO 发生率显著降低。将 RT 与非类固醇抗炎药物进行比较，一项和两项荟萃分析分别显示 RT 在预防严重 HO 方面的疗效显著更高，接受药物治疗的患者的预后更好。关于 RT 的设置，一项荟萃分析分别支持术后和术前 RT。此外，两项荟萃分析表明，多分段 RT 比单分段 RT 更具优势。一项、三项和三项荟萃分析的总体置信度分别为中等、低和极低：结论：RT已被证实是治疗HO的预防性干预措施。结论：RT 是一种已被证实的 HO 预防性干预措施，但如何精确优化时机、剂量和分馏还需要进一步阐明。未来的研究应侧重于通过大规模数据收集和高级分析来开发预测模型，以完善个体化治疗策略并评估 RT 与药物的比较效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.