Rim Chai Hong, Shin In-Soo, Park Sunmin, Lee Hye Yoon
Department of Radiation Oncology, Ansan Hospital, Korea University Medical College, Ansan, Gyeonggi-do, Republic of Korea.
Graduate school of Education, Dongguk University, Seoul, Korea.
NPJ Precis Oncol. 2021 Jan 21;5(1):2. doi: 10.1038/s41698-020-00141-4.
We conducted a meta-analysis of articles published in PubMed, MEDLINE, EMBASE, and Cochrane library to investigate the effectiveness of local consolidative therapy (LCT) against oligometastases. Data from randomized controlled trials (RCTs), balanced studies, and all studies combined were analyzed in a hierarchical manner. Pooled analyses of 31 studies (including seven randomized trials) investigating the effectiveness of LCT on overall survival revealed odds ratios of 3.04, 2.56, and 1.41 for all studies, balanced studies, and RCTs, respectively (all p < 0.05). The benefit of LCT was more prominent in patients with non-small cell lung and colorectal cancers than in those with prostate and small cell lung cancers. Moreover, the benefit of LCT was smaller in patients with high metastatic burdens (p = 0.054). In four of 12 studies with available information, additional grade ≥3 toxicities due to LCTs were reported. Overall, LCT is beneficial for patients with oligometastases, although such benefits are less evident in RCTs than in observational studies. Appropriate LCTs should be carefully selected considering their feasibility, disease type, and metastatic burden.
我们对发表在PubMed、MEDLINE、EMBASE和Cochrane图书馆的文章进行了荟萃分析，以研究局部巩固治疗（LCT）对寡转移的有效性。对随机对照试验（RCT）、平衡研究以及所有研究合并的数据进行了分层分析。对31项研究（包括7项随机试验）进行的汇总分析显示，LCT对总生存期有效性的优势比在所有研究、平衡研究和RCT中分别为3.04、2.56和1.41（所有p<0.05）。LCT对非小细胞肺癌和结直肠癌患者的益处比对前列腺癌和小细胞肺癌患者更为显著。此外，LCT对转移负担高的患者益处较小（p=0.054）。在12项有可用信息的研究中，有4项报告了因LCT导致的额外3级及以上毒性。总体而言，LCT对寡转移患者有益，尽管在RCT中这种益处不如观察性研究明显。应根据LCT的可行性、疾病类型和转移负担仔细选择合适的LCT。
