Ma Jie-Tao, Zheng Jia-He, Han Cheng-Bo, Guo Qi-Yong
Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
Cancer Sci. 2014 Aug;105(8):1015-22. doi: 10.1111/cas.12466.
The purpose of this meta-analysis was to compare higher dose (≥30 Gy) and lower dose (<30 Gy) radiotherapy (RT) on palliation of symptoms and survival in patients with locally advanced lung cancer. A search of PubMed and Google Scholar was conducted on 10 June 2013 using combinations of the search terms: radiotherapy, non-small-cell lung carcinoma, palliative, supportive, symptom relief. Inclusion criteria were: (i) palliative thoracic RT; (ii) randomized controlled trial; (iii) English language; and (iv) compared outcomes between higher dose (≥30 Gy) and lower dose (<30 Gy) RT. The primary outcome was palliation of symptoms (cough, chest pain, hemoptysis), and 1- and 2-year overall survival. Tests of heterogeneity, sensitivity, and publication bias were performed. Five randomized controlled trials with a total of 1730 patients with lung cancer were included in the meta-analysis. There were 925 patients treated with a higher RT dose (≥30 Gy) and 805 treated with a lower RT dose (<30 Gy). The combined odds ratios (ORs) indicated no significant difference in palliation of cough, chest pain, and hemoptysis between the higher dose and lower dose RT groups (combined ORs = 0.88, 1.83, 1.39, respectively). The 1- and 2-year OS rates were similar between the high and low dose RT groups (combined ORs = 1.09 and 1.38, respectively). This meta-analysis indicates that high dose (≥30 Gy) and lower dose (<30 Gy) RT provide similar symptom palliation and 1- and 2-year OS in patients with locally advanced lung cancer.
本荟萃分析的目的是比较高剂量（≥30 Gy）和低剂量（<30 Gy）放疗（RT）对局部晚期肺癌患者症状缓解和生存的影响。2013年6月10日，我们在PubMed和谷歌学术上进行了检索，使用了以下检索词组合：放疗、非小细胞肺癌、姑息性、支持性、症状缓解。纳入标准为：（i）姑息性胸部放疗；（ii）随机对照试验；（iii）英文文献；（iv）比较高剂量（≥30 Gy）和低剂量（<30 Gy）放疗的结果。主要结局是症状缓解（咳嗽、胸痛、咯血）以及1年和2年总生存率。进行了异质性、敏感性和发表偏倚检验。荟萃分析纳入了5项随机对照试验，共1730例肺癌患者。925例患者接受了较高放疗剂量（≥30 Gy），805例接受了较低放疗剂量（<30 Gy）。合并比值比（OR）表明，高剂量和低剂量放疗组在咳嗽、胸痛和咯血缓解方面无显著差异（合并OR分别为0.88、1.83、1.39）。高剂量和低剂量放疗组的1年和2年总生存率相似（合并OR分别为1.09和1.38）。本荟萃分析表明，高剂量（≥30 Gy）和低剂量（<30 Gy）放疗在局部晚期肺癌患者中提供相似的症状缓解以及1年和2年总生存率。
