Clinical outcomes of video-assisted thoracic surgery and stereotactic body radiation therapy for early-stage non-small cell lung cancer: A meta-analysis
Clinical outcomes of video-assisted thoracic surgery and stereotactic body radiation therapy for early-stage non-small cell lung cancer: A meta-analysis
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DOI：
10.1111/1759-7714.12352
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发表时间：
2016-07-01
期刊：
影响因子：
2.9
通讯作者：
Xiang, Jiaqing
中科院分区：
文献类型：
--
作者：
Ma, Longfei;Xiang, Jiaqing
背景：我们比较了电视辅助胸腔镜手术（VATS）肺叶切除术和立体定向全身放射治疗（SABR），以探索治疗早期 NSCLC 患者的临床结果。方法：系统检索主要医学数据库以识别 2010 年 1 月至 2015 年 10 月期间发表的有关 VATS 和 SBRT 的研究。有足够患者和 SBRT 的 I 期和 II 期 NSCLC 的英文出版物 剂量也包括在内。使用多变量随机效应模型进行荟萃分析，以比较 VATS 和 SBRT 之间的总生存期 (OS) 和无病生存期 (DFS)，并调整中位年龄和可手术患者人数。 结果：13 项 VATS（3436 名患者）和 24 项 SBRT（4433 名患者）研究合格。 VATS 患者的中位年龄和随访时间为 68 岁零 42 个月，SBRT 患者的中位年龄和随访时间为 74 岁零 29.4 个月。调整可手术患者比例和中位年龄后，VATS 一年、两年、三年和五年的估计 OS 率分别为 94%、89%、84% 和 69%，而 SBRT 则为 96%、94%、89% 和 82%。 VATS 一年、两年、三年和五年的估计 DFS 率分别为 97%、93%、87% 和 77%，而 SBRT 为 86%、80%、73% 和 58%。结论：调整前，接受 SBRT 治疗的患者与接受 VATS 治疗的患者相比，临床结果较差。接受 SBRT 和 VATS 治疗的患者之间的中位年龄和可手术性之间存在显着差异。调整这些差异后，两种技术之间的 OS 和 DFS 没有显着差异。
Background: We compared video-assisted thoracoscopic surgery (VATS) lobectomy and stereotactic body radiation therapy (SABR) to explore clinical outcomes in the treatment of patients with early stage NSCLC.Methods: Major medical databases were systematically searched to identify studies on VATS and SBRT published between January 2010 and October 2015. English publications of stage I and II NSCLC with adequate patients and SBRT doses were included. A multivariate random effects model was used to perform meta-analysis to compare overall survival (OS) and disease-free survival (DFS) between VATS and SBRT, adjusting for median age and operable patient numbers.Results: Thirteen VATS (3436 patients) and 24 SBRT (4433) studies were eligible. The median age and follow-up duration was 68 years and 42 months for VATS and 74 years and 29.4 months for SBRT patients. After adjusting for the proportion of operable patients and median age, the estimated OS rates at one, two, three, and five years with VATS were 94%, 89%, 84%, and 69% compared with 96%, 94%, 89%, and 82% for SBRT. The estimated DFS rates at one, two, three, and five years with VATS were 97%, 93%, 87%, and 77% compared with 86%, 80%, 73%, and 58% for SBRT.Conclusion: Before adjustment, patients treated with SBRT had poorer clinical outcomes compared to those treated with VATS. A substantial difference between median age and operability exists between patients treated with SBRT and VATS. After adjusting for these differences, OS and DFS did not differ significantly between the two techniques.