局限期SCLC超分割比常规分割放化疗疗效及安全性<i>Meta分析</i>

doi:10.3760/cma.j.issn.1004-4221.2018.03.007

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Abstract Objective To systematically evaluate the differences in efficacy and safety between hyperfractionated and conventionally fractionated radiotherapy for limited-stage small-cell lung cancer (LS-SCLC). Methods A computerized search was performed in PubMed, Embase, Cochrane Library, Web of Science, CBM, Wanfang Data, CNKI, and VIP to collect controlled clinical trials of hyperfractionated versus conventionally fractionated chemoradiotherapy in the treatment of LS-SCLC. The RevMan 5.3 softwarewas used to perform meta-analyses of short-term outcomes, survival data, and adverse events. Results Eight controlled clinical trials involving 1361 patients were enrolled in this study. The results of meta-analysis showed that there were no significant differences in objective response rate or 2-and 5-year overall survival rates between the hyperfractionation group and the conventional fractionation group (odds ratio[OR]=1.31, 95% confidence interval[CI]:0.64-2.69,P=0.46;risk ratio[RR]=1.10, 95%CI:0.98-1.24,P=0.12;RR=1.13,95%CI:0.75-1.69,P=0.56). Compared with the conventional fractionation group, the hyperfractionation group had a significantly higher incidence of grade ≥2 radiation esophagitis (RR=1.74, 95%CI:1.39-2.17,P<0.05). However, there were no significant differences in incidence rates of grade ≥2 radiation pneumonitis or grade >3 hematological toxicity between the two groups (RR=0.73, 95%CI:0.24-2.24,P=0.58;RR=1.18, 95%CI:0.99-1.39,P=0.06). Conclusions In the treatment of LS-SCLC, two fractionation modes show similar short-term efficacy and survival benefits. However, hyperfractionated radiotherapy causes a higher incidence of radiation esophagitis than conventionally fractionated radiotherapy. Given that hyperfractionated radiotherapy is not superior to conventionally fractionated radiotherapy, conventionally fractionated radiotherapy is recommended for treating LS-SCLC.

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	Articles by authors
	Tong Shaodong
	Wang Hui
	Xie Ruilin
	Wang Han
	Qin Zhaohui
	Yao Yuanhu

Key words： Carcinoma,small cell lung/radiotherapy Radiotherapy,hyperfractionated Radiotherapy,conventionally fractionated Meta-analysis

Received: 14 August 2017

Fund:High-level Medical Talents “Six One Project” of Jiangsu Province (LGY2016041);“Six Talent Peaks” Project of Jiangsu Province (2013-WSN-082);Science and Technology Project of Jiangsu Province Department of Health (H201426);Clinical Research Special Fund of Wu Jieping Medical Foundation (320.6799.15035);Project of Xuzhou Municipal Science and Technology Bureau (KC15SH002)

Corresponding Authors: Yao Yuanhu,Email:yyhxz@xzhmu.edu.cn

Cite this article:

Tong Shaodong,Wang Hui,Xie Ruilin et al. Efficacy and safety of hyperfractionated versus conventionally fractionated chemoradiotherapy for limited-stage small-cell lung cancer:a meta-analysis[J]. Chinese Journal of Radiation Oncology, 2018, 27(3): 261-266.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2018.03.007 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2018/V27/I3/261

[1] Prabhakar CN.Epidermal growth factor receptor in non-small cell lung cancer[J].Transl Lung Cancer Res,2015,4(2):110-118.DOI:10.3978/j.issn.2218-6751.2015.01.01.
[2] Aridgides PD,Movsas B,Bogart JA.Thoracic radiotherapy for limited stage small cell lung carcinoma[J].Curr Probl Cancer,2012,36(3):88-105.DOI:10.1016/j.currproblcancer.2012.03.001.
[3] Micke P,Faldum A,Metz T,et al. Staging small cell lung cancer:veterans administration lung study group versus international association for the study of lung cancer—what limits limited disease?[J].Lung Cancer,2002,37(3):271-276.DOI:10.1016/S0169-5002(02) 00072-7.
[4] Faivre-finn C,Snee M,Ashcroft L,et al. Concurrent once-daily versus twice-daily chemoradiotherapy in patients with limited-stage small-cell lung cancer (CONVERT):an open-label,phase 3,randomised,superiority trial[J].Lancet Oncol,2017,18(8):1116-1125.DOI:10.1016/S1470-2045(17)30318-2.
[5] 袁倩倩,张开贤,胡苗苗,等.Ⅲ期小细胞肺癌胸部放疗不同治疗模式的探讨[J].临床和实验医学杂志,2015,14(16):1361-1364.DOI:10.3969/j.issn.1671-4695.2015.016.017.
Yuan QQ,Zhang KX,Hu MM,et al. A study of different patterns of thoracic radiation therapy of small cell lung cancer of stage Ⅲ[J].J Clin Exp Med,2015,14(16):1361-1364.DOI:10.3969/j.issn.1671-4695.2015.016.017.
[6] Han D,Hao SY,Tao C,et al. Comparison of once daily radiotherapy to 60 Gy and twice daily radiotherapy to 45 Gy for limited stage small-cell lung cancer[J].Thorac Cancer,2015,6(5):643-648.DOI:10.1111/1759-7714.12262.
[7] Gazula A,Baldini EH,Chen A,et al. Comparison of once and twice daily radiotherapy for limited stage small-cell lung cancer[J].Lung,2014,192(1):151-158.DOI:10.1007/s00408-013-9518-9.
[8] 王伟力,刘大伟,郭根燕,等.胸部放疗分割与小细胞肺癌预后的关联性研究[J].中国实验诊断学,2013,17(4):680-682.DOI:10.3969/j.issn.1007-4287.2013.04.023.
Wang WL,Liu DW,Guo GY,et al. Correlation between thoracic radiotherapy and the prognosis of small cell lung cancer[J].Chin Labor Diagnost,2013,17(4):680-682.DOI:10.3969/j.issn.1007-4287.2013.04.023.
[9] 夏冰,陈桂园,蔡旭伟,等.局限期小细胞肺癌不同剂量分割模式放疗的疗效分析[J].中华放射肿瘤学杂志,2010,19(6):496-499.DOI:10.3760/cma.j.issn.1004-4221.2010.06.006.
Xia B,Chen GY,Cai XW,et al. The effect of dose fractionation on overall survival in patients with limited-stage small cell lung cancer[J].Chin J Radiat Oncol,2010,19(6):496-499.DOI:10.3760/cma.j.issn.1004-4221.2010.06.006.
[10] Watkins JM,Fortney JA,Wahlquist AE,et al. Once-daily radiotherapy to ≥59.4 Gy versus twice-daily radiotherapy to ≥45.0 Gy with concurrent chemotherapy for limited-stage small-cell lung cancer:a comparative analysis of toxicities and outcomes[J].Jpn J Radiol,2010,28(5):340-348.DOI:10.1007/s11604-010-0429-x.
[11] Bonner JA,Sloan JA,Shanahan TG,et al. Phase Ⅲ comparison of twice-daily split-course irradiation versus once-daily irradiation for patients with limited stage small-cell lung carcinoma[J].J Clin Oncol,1999,17(9):2681-2691.DOI:10.1200/JCO.1999.17.9.2681.
[12] Takada M,Fukuoka M,Kawahara M,et al. Phase Ⅲ study of concurrent versus sequential thoracic radiotherapy in combination with cisplatin and etoposide for limited-stage small-cell lung cancer:results of the Japan Clinical Oncology Group Study 9104[J].J Clin Oncol,2002,20(14):3054-3060.DOI:10.1200/JCO.2002.12.071.
[13] Murray N,Coy P,Pater JL,et al. Importance of timing for thoracic irradiation in the combined modality treatment of limited-stage small-cell lung cancer. The national cancer institute of Canada clinical trials group[J].J Clin Oncol,1993,11(2):336-344.DOI:10.1200/JCO.1993.11.2.336.
[14] Pignon JP,Arriagada R,Ihde DC,et al. A Meta-analysis of thoracic radiotherapy for small-cell lung cancer[J].N Engl J Med,1992,327(23):1618-1624.DOI:10.1056/NEJM199212033272302.
[15] Warde P,Payne D.Does thoracic irradiation improve survival and local control in limited-stage small-cell carcinoma of the lung? A Meta-analysis[J].J Clin Oncol,1992,10(6):890-895.DOI:10.1200/JCO.1992.10.6.890.
[16] Turrisi AT,Kim K,Blum R,et al. Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide[J].N Engl J Med,1999,340(4):265-271.DOI:10.1056/NEJM199901283400403.
[17] Choi NC,Herndon JE,Rosenman J,et al. Phase I study to determine the maximum-tolerated dose of radiation in standard daily and hyperfractionated-accelerated twice-daily radiation schedules with concurrent chemotherapy for limited-stage small-cell lung cancer[J].J Clin Oncol,1998,16(11):3528-3536.DOI:10.1200/JCO.1998.16.11.3528.
[18] de Ruysscher D,Pijls-Johannesma M,Bentzen SM,et al. Time between the first day of chemotherapy and the last day of chest radiation is the most important predictor of survival in limited-disease small-cell lung cancer[J].J Clin Oncol,2006,24(7):1057-1063.DOI:10.1200/JCO.2005.02.9793.