Effect of postoperative radiotherapy on survival in patients with completely resected and pathologically confirmed stage N2 non-small-cell lung cancer: a systematic review and meta-analysis.
Lin Wang, Wenyu Chen, Xiaofei Xu, Wenbo Chen, Derong Bao, Ye Zhang, Yufen Xu
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引用次数: 0
Abstract
Background: The role of postoperative radiotherapy (PORT) for patients with completely resected stage N2 non-small-cell lung cancer (NSCLC) has been controversial. This study aimed to investigate the efficacy of PORT and prognosis in these patients.
Objectives: An updated meta-analysis was conducted in this study to investigate the efficacy of PORT and prognosis in patients with completely resected and pathologically confirmed stage N2 NSCLC.
Design: This study is a systematic review and meta-analysis.
Data source and methods: Databases were searched up to 2 March 2022. All trials on patients with completely resected and pathologically confirmed stage N2 NSCLC undergoing PORT were screened, and data indicators in the PORT and non-PORT groups were extracted, respectively. The effect of PORT on overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) was estimated. Subgroup and sensitivity analyses were performed.
Results: In all, 20 studies involving 6340 patients were finally included. The PORT significantly increased OS [hazard ratio (HR) = 0.77, 95% CI: 0.71-0.84, p < 0.001), LRFS (HR = 0.63, 95% CI: 0.52-0.76, p < 0.001), and DFS (HR = 0.72, 95% CI: 0.63-0.82, p < 0.001) while it showed no significant difference in improving DMFS (HR = 0.86, 95% CI: 0.71-1.05, p = 0.14).
Conclusion: Our results suggest that in the postoperative treatment of patients with completely resected and pathologically confirmed stage N2 NSCLC, the addition of PORT provides better local recurrence control and survival benefit, but no benefit for distant metastases. The PORT may be incorporated into the postoperative treatment options for some patients with high-risk factors. However, it needs to be validated by more prospective studies in the future.
背景:术后放疗(PORT)在完全切除的N2期非小细胞肺癌(NSCLC)患者中的作用一直存在争议。本研究旨在探讨PORT治疗这些患者的疗效及预后。目的:本研究进行了一项更新的荟萃分析，探讨PORT在完全切除并病理证实的N2期NSCLC患者中的疗效和预后。设计:本研究采用系统综述和荟萃分析。数据来源和方法:检索截止到2022年3月2日的数据库。筛选所有接受PORT手术的完全切除且病理证实的N2期NSCLC患者的试验，分别提取PORT组和非PORT组的数据指标。估计PORT对总生存期(OS)、无病生存期(DFS)、局部无复发生存期(LRFS)和远端无转移生存期(DMFS)的影响。进行亚组分析和敏感性分析。结果:最终共纳入20项研究，涉及6340例患者。PORT显著增加OS[风险比(HR) = 0.77, 95% CI: 0.71-0.84, p p p p = 0.14]。结论:我们的研究结果表明，在完全切除并病理证实的N2期NSCLC患者的术后治疗中，PORT的加入可以更好地控制局部复发和生存，但对远处转移没有好处。对于一些有高危因素的患者，PORT可纳入术后治疗方案。然而，这需要在未来进行更多的前瞻性研究来验证。试验注册:CRD42022314095。
期刊介绍：
Therapeutic Advances in Chronic Disease publishes the highest quality peer-reviewed research, reviews and scholarly comment in the drug treatment of all chronic diseases. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers involved in the medical treatment of chronic disease, providing a forum in print and online for publishing the highest quality articles in this area.
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