一项比较超分割放疗与常规分割放疗用于非小细胞肺癌的荟萃分析。
A meta-analysis comparing hyperfractionated vs. conventional fractionated radiotherapy in non-small cell lung cancer.
作者信息
Zhang Weisan, Liu Qian, Dong Xifeng, Lei Ping
机构信息
1 Department of Geriatrics, 2 Tianjin Lung Cancer Institute, 3 Department of Hematology-Oncology, Tianjin Medical University General Hospital, Tianjin 300052, China.
出版信息
J Thorac Dis. 2015 Mar;7(3):478-85. doi: 10.3978/j.issn.2072-1439.2015.02.20.
BACKGROUND
Lung cancer is the leading cause of cancer-related mortality. Non-small cell lung cancer (NSCLC) accounts for most lung cancer and carries a 5-year survival rate of 15%. The squamous cell carcinoma, large cell carcinoma, and adenocarcinoma are the most common types of NSCLC. The data on long term use of hyperfractionated radiotherapy (HRT) in NSCLC treatment is lacking. We performed a meta-analysis, based on published randomized trials to compare HRT [continuous hyperfractionated accelerated radiotherapy (CHART)/continuous hyperfractionated accelerated radiotherapy weekend less (CHARTWEL)] vs. conventional fractionated (CF) radiotherapy in the treatment of NSCLC.
METHODS
A systematic search through the bibliographic databases, PubMed, Google Scholar and Cochrane Library was performed till December 2013.
RESULTS
Of 63 studies identified, 3 studies were analyzed. All were randomized studies and included 1,005 patients in total. The pooled results of the studies showed that HRT did not improve overall survival (OS) of patients suffering from NSCLC compared to CF after 2 years (OR, 1.29; 95% CI, 0.98-1.71; P=0.16) and 3 years (OR, 0.55; 95% CI, 0.34-0.87; P=0.22) which was statistically significant. HRT was no better than CF in controlling tumour (OR, 1.40; 95% CI, 1.03-1.91). No significant difference in metastasis free survival (OR, 1.08; 95% CI, 0.83-1.39) and late dysphagia (OR, 1.48; 95% CI, 0.75-2.92) were observed between the two groups.
CONCLUSIONS
The results of the present meta-analysis showed that HRT was not significantly better to conventional radiotherapy in NSCLC treatment.
背景
肺癌是癌症相关死亡的主要原因。非小细胞肺癌（NSCLC）占大多数肺癌病例，其5年生存率为15%。鳞状细胞癌、大细胞癌和腺癌是NSCLC最常见的类型。缺乏关于在NSCLC治疗中长期使用超分割放疗（HRT）的数据。我们基于已发表的随机试验进行了一项荟萃分析，以比较HRT[连续超分割加速放疗（CHART）/连续超分割加速放疗周末减量（CHARTWEL）]与常规分割（CF）放疗在NSCLC治疗中的效果。
方法
截至2013年12月，通过文献数据库、PubMed、谷歌学术和考克兰图书馆进行了系统检索。
结果
在识别出的63项研究中，分析了3项研究。所有研究均为随机研究，共纳入1005例患者。研究的汇总结果显示，与CF相比，HRT在2年（OR，1.29；95%CI，0.98 - 1.71；P = 0.16）和3年（OR，0.55；95%CI，0.34 - 0.87；P = 0.22）后并未改善NSCLC患者的总生存期（OS），差异具有统计学意义。在控制肿瘤方面，HRT并不优于CF（OR，1.40；95%CI，1.03 - 1.91）。两组之间在无转移生存期（OR，1.08；95%CI，0.83 - 1.39）和晚期吞咽困难（OR，1.48；95%CI，0.75 - 2.92）方面未观察到显著差异。
结论
本荟萃分析结果表明，在NSCLC治疗中，HRT并不显著优于传统放疗。
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