摘要目的:分析多次分割单纯高剂量率近距离治疗（HDR-BT）在局限性前列腺癌患者中的疗效及不良反应。方法:通过计算机检索国内外相关数据库，搜集有关局限期前列腺癌行单纯HDR-BT的临床研究资料，纳入的研究仅限多次分割HDR-BT单一治疗，中位随访时间至少为5年，分析了详细的疗效及不良反应数据。采用Stata 12.0软件进行分析。结果:根据纳入排除标准，最终纳入11项包括2 683例患者的临床研究资料。meta分析结果显示：总的5年无生化复发生存（bRFS）率和总生存（OS）率分别为94%（95% CI为93%~96%）和96%（95% CI为94%~98%）。总的长期（≥5年）肿瘤特异性生存（CSS）率和无远处转移生存（DMFS）率分别为99%（95% CI为98%~100%）和98%（95% CI为98%~99%）。总的长期（≥5年）晚期≥3级胃肠和泌尿系统不良反应发生率分别为2%（95% CI为1%~3%）和9%（95% CI为6%~13%）。 结论:多次分割单纯HDR-BT对于局限期前列腺癌患者是一种有效的治疗手段，其长期疗效结果令人鼓舞，且治疗的耐受性和安全性良好。

abstractsObjective:To conduct a meta-analysis to analyze the efficacy and adverse reactions of fractionated high dose rate brachytherapy (HDR-BT) as monotherapy for localized prostate cancer.Methods:Relevant databases were searched to collect the clinical trials on HDR-BT as monotherapy in patients with localized prostate cancer. Included studies were limited to full-text publications of fractionated HDR-BT as monotherapy with a median follow-up of at least 5 years, and adequate reporting of treatment outcomes and adverse reactions data. Stata 12.0 was used for data analysis.Results:According to the inclusion and exclusion criteria, a total of 11 clinical trials involving 2 683 patients with prostate cancer were included in this meta-analysis. The results of the meta-analysis showed that 5-year biochemical recurrence-free survival (bRFS) rate and overall survival (OS) rate were 94% (95% CI: 93% - 96%) and 96% (95% CI: 94% - 98%), respectively. Long-term (≥5 years) cancer-specific survival (CSS) rate and distant metastasis-free survival (DMFS) rate were 99% (95% CI: 98% - 100%) and 98% (95% CI: 98% - 99%), respectively. Long-term (≥5 years) late grade ≥3 grade gastrointestinal and genitourinary adverse reactions rates were 2% (95% CI: 1% - 3%) and 9% (95% CI: 6% - 13%), respectively. Conclusions:Fractionated HDR-BT as monotherapy is an effective treatment for patients with localized prostate cancer. Its long-term efficacy is encouraging, and the treatment is well tolerated and safe.