局部晚期非小细胞肺癌的受累野放疗（IFRT）与选择性淋巴结照射（ENI）：选择性淋巴结失败（ENF）发生率的荟萃分析
Involved field radiotherapy (IFRT) versus elective nodal irradiation (ENI) for locally advanced non-small cell lung cancer: a meta-analysis of incidence of elective nodal failure (ENF).
作者信息
Li Ruijian, Yu Liang, Lin Sixiang, Wang Lina, Dong Xin, Yu Lingxia, Li Weiyi, Li Baosheng
机构信息
Department of Radiation Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong University, Provincial Key Laboratory of Radiation Oncology, Jiyan Road 440, 250117, Jinan, Shandong, China.
Department of Radiation Oncology II, Yantai Affiliated Hospital of Binzhou Medical University, Key Department of Yantai Health Bureau, Yantai, Shandong, China.
出版信息
Radiat Oncol. 2016 Sep 21;11(1):124. doi: 10.1186/s13014-016-0698-3.
BACKGROUND AND PURPOSE
The use of involved field radiotherapy (IFRT) has generated concern about the increasing incidence of elective nodal failure (ENF) in contrast to elective nodal irradiation (ENI). This meta-analysis aimed to provide more reliable and up-to-date evidence on the incidence of ENF between IFRT and ENI.
MATERIALS AND METHODS
We searched three databases for eligible studies where locally advanced non-small cell lung cancer (NSCLC) patients received IFRT or ENI. Outcome of interest was the incidence of ENF. The fixed-effects model was used to pool outcomes across the studies.
RESULTS
There were 3 RCTs and 3 cohort studies included with low risk of bias. There was no significant difference in incidence of ENF between IFRT and ENI either among RCTs (RR = 1.38, 95 % CI: 0.59-3.25, p = 0.46) or among cohort studies (RR = 0.99, 95 % CI: 0.46-2.10, p = 0.97). There was also no significant difference in incidence of ENF between IFRT and ENI when RCTs and cohort studies were combined (RR = 1.15, 95 % CI: 0.65-2.01, p = 0.64). I of test for heterogeneity was 0 %.
CONCLUSION
This meta-analysis provides more reliable and stable evidence that there is no significant difference in incidence of ENF between IFRT and ENI.
背景与目的
与选择性淋巴结照射（ENI）相比，累及野放射治疗（IFRT）的应用引发了人们对选择性淋巴结失败（ENF）发生率上升的担忧。本荟萃分析旨在提供关于IFRT和ENI之间ENF发生率的更可靠和最新的证据。
材料与方法
我们在三个数据库中搜索了符合条件的研究，这些研究中的局部晚期非小细胞肺癌（NSCLC）患者接受了IFRT或ENI。感兴趣的结果是ENF的发生率。采用固定效应模型汇总各项研究的结果。
结果
纳入了3项随机对照试验（RCT）和3项队列研究，偏倚风险较低。在RCT中（风险比[RR]=1.38，95%置信区间[CI]：0.59 - 3.25，p = 0.46）或队列研究中（RR = 0.99，95% CI：0.46 - 2.10，p = 0.97），IFRT和ENI之间的ENF发生率均无显著差异。当将RCT和队列研究合并时，IFRT和ENI之间的ENF发生率也无显著差异（RR = 1.15，95% CI：0.65 - 2.01，p = 0.64）。异质性检验的I²为0%。
结论
本荟萃分析提供了更可靠和稳定的证据，表明IFRT和ENI之间的ENF发生率无显著差异。
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