Arriagada R, Pignon J P, Ihde D C, Johnson D H, Perry M C, Souhami R L, Brodin O, Joss R A, Kies M S, Lebeau B
Department of Radiotherapy, Institut Gustave-Roussy, Villejuif, France.
Anticancer Res. 1994 Jan-Feb;14(1B):333-5.
This meta-analysis was designed to evaluate the hypothesis that thoracic radiotherapy contributes to a moderate increase in overall survival in limited small-cell lung cancer. We collected individual data on all patients enrolled before December 1988 in randomized trials comparing chemotherapy alone with chemotherapy combined with thoracic radiotherapy. The study included 13 trials and 2140 patients with limited disease. A total of 433 patient with extensive disease were excluded. Overall, 1862 of 2103 patients who could be evaluated died; the median follow-up period for the surviving patients was 43 months. The relative risk of death in the combined therapy group as compared with the chemotherapy group was 0.86 (95 percent confidence interval, 0.78 to 0.94; P = 0.001), corresponding to a 14 percent reduction in the mortality rate. The benefit in terms of overall survival at three years (+/- SD) was 5.4 +/- 1.4 percent. Indirect comparison of early with late radiotherapy and of sequential with non-sequential radiotherapy did not reveal any optimal time for treatment. There was a trend toward a larger reduction in mortality among younger patients. In conclusion, thoracic radiotherapy moderately improves overall survival in patients with limited small-cell lung cancer who are treated with combination chemotherapy.
胸部放疗有助于适度提高局限期小细胞肺癌患者的总生存率。我们收集了1988年12月之前纳入的所有患者的个体数据，这些患者来自比较单纯化疗与化疗联合胸部放疗的随机试验。该研究纳入了13项试验和2140例局限期患者。总共排除了433例广泛期患者。总体而言，在2103例可评估的患者中，有1862例死亡；存活患者的中位随访期为43个月。联合治疗组与化疗组相比的死亡相对风险为0.86（95%置信区间为0.78至0.94；P = 0.001），相当于死亡率降低了14%。三年时总生存率（±标准差）的获益为5.4±1.4%。早期放疗与晚期放疗以及序贯放疗与非序贯放疗的间接比较未发现任何最佳治疗时间。年轻患者的死亡率有更大幅度降低的趋势。总之，胸部放疗可适度提高接受联合化疗的局限期小细胞肺癌患者的总生存率。
