Precision thoracic radiotherapy in limited-stage small cell lung cancer:a network meta-analysis
Yang Tao1, Cao Lijuan2, Jiang Xiaodong1, Fan Yuwei1, Li Jia1, Wu Dan1, Chen Hanbo1, Xia Youyou1
1Department of Radiation Oncology, the First People's Hospital of Lianyungang City, Lianyungang 222002, China; 2Department of Healthcare-associated Infection Management, the First People's Hospital of Lianyungang City, Lianyungang 222002, China
Abstract：Objective To systematically evaluate the efficacy and safety of precision thoracic radiotherapy (TRT) in the limited-stage small cell lung cancer (LS-SCLC) patients by network meta-analysis. Methods Randomized controlled trials (RCTs) of TRT regimes in the LS-SCLC were electronically searched from PubMed, Web of Science, The Cochrane Library, CNKI and Wanfang Data from inception to September 1st, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Statistical analysis was performed by Stata 17 and R 4.1.1software. Results A total of 6 RCTs involving 1730 patients with six radiation regimens including hyperfractionated radiotherapy (HFRT):HFRT45(45Gy/30 F) and HFRT60(60Gy/40 F);conventional fractionated radiotherapy (CFRT):CFRT70(70Gy/35 F) and CFRT66(66Gy/33 F);moderately hypofractionated radiotherapy (MHFRT):MHFRT65(65Gy/26 F) and MHFRT42(42Gy/15 F) were included. The network meta-analysis showed that:in terms of improving progression-free survival and overall survival, there was no statistically significant difference among the six radiotherapy regimens. The probabilistic ranking results were:MHFRT65 > HFRT60 > CFRT66 > CFRT70 > MHFRT42 > HFRT45, and HFRT60 > MHFRT65 > CFRT66 > CFRT70 > HFRT45 > MHFRT42, respectively. The HFRT60 regimen was superior to other regimens in reducing the incidence of grade ≥3 pneumonia, and there was no difference between the regimens in causing grade ≥3 radiation esophagitis, and the results of ranking probability were:HFRT60 > MHFRT42 > CFRT66 > CFRT70 > HFRT45 > MHFRT65, and HFRT60 > CFRT70 > CFRT66 > HFRT45 > MHFRT42 > MHFRT65, respectively. Conclusions HFRT60 radiotherapy regimen may be more effective and safer in the treatment of LS-SCLC patients as a priority choice for LS-SCLC TRT. Limited by the number and quality of included studies, the above conclusions need to be verified by more high-quality studies.
Yang Tao,Cao Lijuan,Jiang Xiaodong et al. Precision thoracic radiotherapy in limited-stage small cell lung cancer:a network meta-analysis[J]. Chinese Journal of Radiation Oncology, 2022, 31(5): 431-437.
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