Stereotactic body radiotherapy versus surgery for resectable stage Ⅰ non-small cell lung cancer:a systematic evaluation
Bai Ge,Chu Jianhu,Bao Yongxing,Mnyinuer·Eli,Zheang Chao,Ma Le,Zhang Li
Department of Oncology (Bai G,Bao YX,Mayinuer·Eli,Zheang CH,Ma L),Department of Internal Medicine VIP (Zhang L),First Affiliated Hospital,Xinjiang Medical University,Urumqi 830011,China;Deaprtment of Thoracic Surgery, Cancer Hospital of Xinjiang Medical University,Urumqi 830011,China (Chu Jianhu)
Abstract：Objective To systematically evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for resectable stage Ⅰ non-small cell lung cancer (NSCLC). Methods Clinical trials of SBRT or surgery for resectable stage Ⅰ NSCLC were collected by computerized search of Cochrane Library, MEDLINE, EMbase, CBM, CNKI, and VIP. Literature selection, quality evaluation, and data extraction were performed by two inspectors based on the inclusion and exclusion criteria. A meta-analysis was performed on the enrolled studies using RevMan 5.3 software. Results A total of four clinical trials involving 410 patients were included. The results of meta-analysis showed that there was no significant difference in 3-year overall survival rate between SBRT and surgery (RR=1.13, 95%CI=0.66-1.94, P=0.66);there was no significant difference in local control rate between SBRT and surgery (RR=0.71, 95%CI=0.26-1.93, P=0.50);patients treated with SBRT had significantly lower incidence rates of grade 3-4 adverse reactions than those treated with surgery (RR=0.29, 95%CI=0.16-0.53, P=0.000). Conclusions SBRT shows equivalent efficacy to surgery in the treatment of resectable stage Ⅰ NSCLC. However, due to the limitations in this systematic evaluation, the conclusion needs to be further confirmed by large randomized controlled trials.
Bai Ge,Chu Jianhu,Bao Yongxing et al. Stereotactic body radiotherapy versus surgery for resectable stage Ⅰ non-small cell lung cancer:a systematic evaluation[J]. Chinese Journal of Radiation Oncology, 2016, 25(7): 690-693.
[1]Grills IS,Mangona VS,Welsh R,et al. Outcomes after stereotactic lung radiotherapy or wedge resection for stage Ⅰ non-small-cell lung cancer[J].J Clin Oncol,2010,28(6):928-935.DOI:10.1200/JCO.2009.25.0928 [2]Verstegen NE,Oosterhuis JWA,Palma DA,et al. Stage Ⅰ-Ⅱ non-small-cell lung cancer treated using either stereotactic ablative radiotherapy (SABR) or lobectomy by video-assisted thoracoscopic surgery (VATS):outcomes of a propensity score-matched analysis[J].Ann Oncol,2013,24(6):1543-1548.DOI:10.1093/annonc/mdt026 [3]Crabtree TD,Denlinger CE,Meyers BF,et al. Stereotactic body radiation therapy versus surgical resection for stage Ⅰ non-small cell lung cancer[J].J Thorac Cardiovasc Surg,2010,140(2):377-386.DOI:10.1016/j.jtcvs.2009.12.054 [4]Chang JY,Senan S,Paul MA,et al. Stereotactic ablative radiotherapy versus lobectomy for operable Stage Ⅰ non-small-cell lung cancer:a pooled analysis of two randomised trials[J].Lancet Oncol,2015,16(6):630-637.DOI:10.1016/S1470-2045(15)70168-3 [5]Lou F,Huang J,Sima CS,et al. Patterns of recurrence and second primary lung cancer in early-stage lung cancer survivors followed with routine computed tomography surveillance[J].J Thorac Cardiovasc Surg,2013,145(1):75-81.DOI:10.1016/j.jtcvs.2012.09.030 [6]Onishi H,Shirato H,Nagata Y,et al. Stereotactic body radiotherapy (SBRT) for operable stage Ⅰ non-small-cell lung cancer:can SBRT be comparable to surgery?[J].Int J Radiat Oncol Biol Phys,2011,81(5):1352-1358.DOI:10.1016/j.ijrobp.2009.07.1751 [7]Nagata Y,Hiraoka M,Shibata T,et al. A phase Ⅱ trial of stereotactic body radiation therapy for operable TIN0M0 non-small cell lung cancer:Japan clinical oncology group (JCOG0403)[J].Int J Radiat Oncol Biol Phys,2010,78(3):S27-S28.DOI:10.1016/j.ijrobp.2010.07.104 [8]Grutters JPC,Kessels AGH,Pijls-Johannesma M,et al. Comparison of the effectiveness of radiotherapy with photons,protons and carbon-ions for non-small cell lung cancer:a meta-analysis[J].Radiother Oncol,2010,95(1):32-40.DOI:10.1016/j.radonc.2009.08.003.
2016, Vol. 25 
