粒子束治疗与立体定向体部放射治疗用于早期非小细胞肺癌的比较：一项系统评价和生成假设的荟萃分析。
Comparison of particle beam therapy and stereotactic body radiotherapy for early stage non-small cell lung cancer: A systematic review and hypothesis-generating meta-analysis.
作者信息
Chi Alexander, Chen Haiquan, Wen Sijin, Yan Haijuan, Liao Zhongxing
机构信息
Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, China.
Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, China.
出版信息
Radiother Oncol. 2017 Jun;123(3):346-354. doi: 10.1016/j.radonc.2017.05.007. Epub 2017 May 22.
Abstract
PURPOSE
To assess hypo-fractionated particle beam therapy (PBT)'s efficacy relative to that of photon stereotactic body radiotherapy (SBRT) for early stage (ES) non-small cell lung cancer (NSCLC).
METHODS
Eligible studies were identified through extensive searches of the PubMed, Medline, Google-scholar, and Cochrane library databases from 2000 to 2016. Original English publications of ES NSCLC were included. A meta-analysis was performed to compare the survival outcome, toxicity profile, and patterns of failure following each treatment.
RESULTS
72 SBRT studies and 9 hypo-fractionated PBT studies (mostly single-arm) were included. PBT was associated with improved overall survival (OS; p=0.005) and progression-free survival (PFS; p=0.01) in the univariate meta-analysis. The OS benefit did not reach its statistical significance after inclusion of operability into the final multivariate meta-analysis (p=0.11); while the 3-year local control (LC) still favored PBT (p=0.03).
CONCLUSION
Although hypo-fractionated PBT may lead to additional clinical benefit when compared with photon SBRT, no statistically significant survival benefit from PBT over SBRT was observed in the treatment of ES NSCLC in this hypothesis-generating meta-analysis after adjusting for potential confounding variables.
摘要
目的
评估低分割粒子束疗法（PBT）相较于光子立体定向体部放疗（SBRT）治疗早期（ES）非小细胞肺癌（NSCLC）的疗效。
方法
通过广泛检索2000年至2016年的PubMed、Medline、谷歌学术和考克兰图书馆数据库确定符合条件的研究。纳入ES NSCLC的英文原始出版物。进行荟萃分析以比较每种治疗后的生存结果、毒性特征和失败模式。
结果
纳入了72项SBRT研究和9项低分割PBT研究（大多为单臂研究）。在单变量荟萃分析中，PBT与总生存期（OS；p = 0.005）和无进展生存期（PFS；p = 0.01）改善相关。在最终的多变量荟萃分析中纳入可手术性后，OS获益未达到统计学显著性（p = 0.11）；而3年局部控制率（LC）仍有利于PBT（p = 0.03）。
结论
尽管与光子SBRT相比，低分割PBT可能带来额外的临床益处，但在这项产生假设的荟萃分析中，在调整潜在混杂变量后，未观察到PBT在治疗ES NSCLC方面比SBRT有统计学显著的生存获益。
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