Choi Hoon Sik, Jeong Bae Kwon, Kang Ki Mun, Jeong Hojin, Song Jin Ho, Ha In Bong, Kwon Oh-Young
Department of Radiation Oncology and Institute of Health Science, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea.
Department of Radiation Oncology and Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.
Cancer Res Treat. 2020 Oct;52(4):1188-1198. doi: 10.4143/crt.2020.402. Epub 2020 Jul 21.
In pulmonary oligometastases from colorectal cancer (POM-CRC), the primarily recommended local therapy is metastasectomy. Stereotactic body radiotherapy (SBRT) is another local therapy modality that is considered as an alternative option in patients who cannot undergo surgery. The purpose of this meta-analysis is to demonstrate the effects of SBRT on POM-CRC by integrating the relevant studies.
The authors explored MEDLINE, EMBASE, Cochrane Library, Web of Science, and SCOPUS, and selected studies including patients treated with SBRT for POM-CRC and availability of local control (LC) or overall survival (OS) rate. In this meta-analysis, the effect of SBRT was presented in the form of the LC and OS rates for 1, 2, 3, and 5 years after SBRT as pooled estimates, and the frequency of pulmonary toxicity of grade 3 or higher after SBRT (PTG3-SBRT).
Fourteen full texts among the searched 4,984 studies were the objects of this meta-analysis. The overall number of POM-CRC patients was 495 as per the integration of 14 studies. The pooled estimate LC rate at 1, 2, 3, and 5 years after SBRT was 81.0%, 71.5%, 56.0%, and 61.8%, and the OS rate was 86.9%, 70.1%, 57.9%, and 43.0%, respectively. The LC and OS rates gradually declined until 3 years after SBRT in a similar pattern. Among the 14 studies, only two studies reported PTG3-SBRT as 2.2% and 10.8%, respectively.
For POM-CRC, SBRT is an ablative therapy with a benefit on LC and OS rates and less adverse effects on the lung.
在结直肠癌肺寡转移（POM-CRC）中，主要推荐的局部治疗方法是转移灶切除术。立体定向体部放疗（SBRT）是另一种局部治疗方式，被视为无法接受手术的患者的替代选择。本荟萃分析的目的是通过整合相关研究来证明SBRT对POM-CRC的疗效。
作者检索了MEDLINE、EMBASE、Cochrane图书馆、科学网和SCOPUS，并选择了包括接受SBRT治疗的POM-CRC患者以及局部控制（LC）或总生存率（OS）数据的研究。在本荟萃分析中，SBRT的疗效以SBRT后1、2、3和5年的LC和OS率的合并估计值形式呈现，以及SBRT后3级或更高等级的肺部毒性发生率（PTG3-SBRT）。
在检索的4984项研究中，14篇全文是本荟萃分析的对象。根据14项研究的整合，POM-CRC患者总数为495例。SBRT后1、2、3和5年的合并估计LC率分别为81.0%、71.5%、56.0%和61.8%，OS率分别为86.9%、70.1%、57.9%和43.0%。LC和OS率在SBRT后3年内以相似模式逐渐下降。在14项研究中，只有两项研究分别报告PTG3-SBRT为2.2%和10.8%。
对于POM-CRC，SBRT是一种消融治疗，对LC和OS率有益，且对肺部的不良反应较少。
