广泛期小细胞肺癌治疗中是否进行预防性颅脑照射的Meta分析：困境依然存在。
Meta-analysis of prophylactic cranial irradiation or not in treatment of extensive-stage small-cell lung cancer: The dilemma remains.
作者信息
Wen P, Wang T F, Li M, Yu Y, Zhou Y L, Wu C L
机构信息
Department of Radiation Oncology, the Fourth Affiliated Hospital of China Medical University, No.4 East Chongshan Road, Shenyang 110032, Liaoning Province, China.
Department of Radiation Oncology, the Fourth Affiliated Hospital of China Medical University, No.4 East Chongshan Road, Shenyang 110032, Liaoning Province, China.
出版信息
Cancer Radiother. 2020 Feb;24(1):44-52. doi: 10.1016/j.canrad.2019.10.001. Epub 2020 Feb 7.
PURPOSE
The role of prophylactic cranial irradiation (PCI) in treatment of extensive-stage small-cell lung cancer (SCLC) is controversial. The aim of this study was to systematically evaluate the efficacy and safety of using PCI in the treatment of extensive-stage SCLC. In the present study, we examined whether PCI was essential for the optimal treatment of extensive-disease small-cell lung cancer.
MATERIAL AND METHODS
We searched the PubMed, Embase, Medline, and China National Knowledge Infrastructure databases to identify articles that assessed the efficacy of PCI in treating extensive-stage small-cell lung cancer patients.
RESULTS
We identified 8 studies that involved a total of 982 patients who received PCI (PCI group) and a total of 4509 patients who did not receive PCI (control group). The results showed that PCI significantly improved the 1-year overall survival rate (HR=1.50; 95% CI: 1.23-1.82; I=67%; P<0.0001) and reduced the incidence of brain metastasis (HR=0.46; 95% CI: 0.37-0.58; I=6%; P<0.00001).
CONCLUSION
PCI improves the 1-year overall survival rate and reduces the risk of brain metastasis in patients with extensive-stage SCLC.
目的
预防性颅脑照射（PCI）在广泛期小细胞肺癌（SCLC）治疗中的作用存在争议。本研究旨在系统评价PCI治疗广泛期SCLC的疗效和安全性。在本研究中，我们探讨了PCI对于广泛期小细胞肺癌的最佳治疗是否必不可少。
材料与方法
我们检索了PubMed、Embase、Medline和中国知网数据库，以识别评估PCI治疗广泛期小细胞肺癌患者疗效的文章。
结果
我们确定了8项研究，共纳入982例接受PCI的患者（PCI组）和4509例未接受PCI的患者（对照组）。结果显示，PCI显著提高了1年总生存率（HR=1.50；95%CI：1.23-1.82；I=67%；P<0.0001），并降低了脑转移的发生率（HR=0.46；95%CI：0.37-0.58；I=6%；P<0.00001）。
结论
PCI可提高广泛期SCLC患者的1年总生存率，并降低脑转移风险。
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