Taha Yasir A
Internal Medicine department, College of Medicine, Najran University, Najnan, KSA, Saudi Arabia.
J Egypt Natl Canc Inst. 2025 Apr 29;37(1):27. doi: 10.1186/s43046-025-00271-5.
Lung cancer is the leading cause of cancer-related mortality worldwide. Approximately 15-20% of newly diagnosed individuals with primary lung cancer have small cell lung cancer, and more than 60% of patients have advanced-stage small cell lung cancer at the time of diagnosis. Patients with advanced-stage small-cell lung cancer may benefit from thoracic radiation therapy. This comprehensive meta-analysis was conducted to determine whether adding thoracic radiation to systemic chemotherapy increases 1-year and 2-year survival in patients with advanced-stage small-cell lung cancer.
The Science Direct, PubMed, Embase, and Wanfang databases were comprehensively searched from 1980 to 2022. The inclusion criteria for studies were as follows: (1) all patients had advanced-stage small cell lung cancer; (2) a group receiving thoracic radiation therapy combined with chemotherapy was compared with a group receiving only chemotherapy; and (3) 1-year and 2-year overall survival data were provided. Pooled relative risks (RRs) and risk differences (RDs) were calculated, publication bias was evaluated, and sensitivity analysis was conducted.
Ten studies met the inclusion criteria. These studies included 922 patients (534 patients in the chemotherapy combined with thoracic radiation therapy (ChT/TRT) group and 388 patients in the chemotherapy (ChT) group). The results of the meta-analysis revealed that the addition of thoracic radiotherapy to chemotherapy increased the 1-year overall survival rate to 52%, whereas the 1-year overall survival rate was 32.2% when chemotherapy alone was used. The addition of thoracic radiotherapy to chemotherapy also increased the 2-year survival rate to 18.7%, compared with 10% in the ChT group. The ChT/TRT group had a significantly better 1-year overall survival rate than the ChT group, with a pooled RR of 1.61 (95% CI, 1.36-1.90, P < 0.00001) and a pooled RD of 0.2 (95% CI, 0.13-0.26, P < 0.00001). The ChT/TRT group also had a significantly better 2-year overall survival rate than the ChT group, with a pooled RR of 1.90 (95% CI, 1.34-2.68, P = 0.0003) and a pooled RD of 0.09 (95% CI, 0.05-0.13, P < 0.0001).
This study revealed that adding thoracic radiation therapy to chemotherapy increases both 1-year and 2-year survival in patients with extensive-stage small-cell lung cancer.
肺癌是全球癌症相关死亡的主要原因。新诊断的原发性肺癌患者中，约15%-20%为小细胞肺癌，超过60%的患者在诊断时已处于晚期小细胞肺癌阶段。晚期小细胞肺癌患者可能从胸部放射治疗中获益。本项综合荟萃分析旨在确定在全身化疗基础上加用胸部放疗是否能提高晚期小细胞肺癌患者的1年和2年生存率。
全面检索了1980年至2022年的Science Direct、PubMed、Embase和万方数据库。研究的纳入标准如下：（1）所有患者均为晚期小细胞肺癌；（2）将接受胸部放疗联合化疗的组与仅接受化疗的组进行比较；（3）提供1年和2年总生存数据。计算合并相对风险（RRs）和风险差异（RDs），评估发表偏倚，并进行敏感性分析。
10项研究符合纳入标准。这些研究共纳入922例患者（化疗联合胸部放疗（ChT/TRT）组534例，化疗（ChT）组388例）。荟萃分析结果显示，化疗联合胸部放疗可使1年总生存率提高至52%，而单纯化疗时1年总生存率为32.2%。化疗联合胸部放疗也使2年生存率提高至18.7%，而ChT组为10%。ChT/TRT组的1年总生存率显著高于ChT组，合并RR为1.61（95%CI，1.36-1.90，P < 0.00001），合并RD为0.2（95%CI，0.13-0.26，P < 0.00001）。ChT/TRT组的2年总生存率也显著高于ChT组，合并RR为1.90（95%CI，1.34-2.68，P = 0.0003），合并RD为0.09（95%CI，0.05-0.13，P < 0.0001）。
本研究表明，在化疗基础上加用胸部放疗可提高广泛期小细胞肺癌患者的1年和2年生存率。
