Prophylactic cranial irradiation in small cell lung cancer: a systematic review of the literature with meta-analysis.
Prophylactic cranial irradiation in small cell lung cancer: a systematic review of the literature with meta-analysis.
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DOI：
10.1186/1471-2407-1-5
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发表时间：
2001
期刊：
影响因子：
3.8
通讯作者：
Sculier JP
中科院分区：
文献类型：
--
作者：
Meert AP;Paesmans M;Berghmans T;Martin B;Mascaux C;Vallot F;Verdebout JM;Lafitte JJ;Sculier JP
我们对相关文献进行了系统回顾，以确定预防性颅脑照射（PCI）在小细胞肺癌（SCLC）中的作用。为了符合条件，完整发表的试验需要处理SCLC，并随机分配患者接受PCI或不接受PCI。试验质量通过两个评分（Chalmers和ELCWP）来评估。12项随机试验（1547例患者）被发现符合条件。5项研究评估了PCI在化疗后完全缓解（CR）的SCLC患者中的作用。在5项研究中进行了脑部CT扫描，在6项研究中进行了脑部扫描。Chalmers和ELCWP评分相关性良好（p < 0.001），中位评分分别为32.6%和38.8%。这项基于现有已发表数据的荟萃分析显示，脑转移发生率降低(风险比（HR）： 0.48；95%可信区间（CI）： 0.39 - 0.60)和CR患者的生存率（HR: 0.82; 95% CI: 0.71 - 0.96）的改善有利于PCI组。不幸的是，长期的神经毒性没有得到充分的描述。PCI降低了CR - SCLC患者的脑转移发生率并提高了生存率，但这些效果仅在未进行系统神经心理学和脑成像评估的患者中获得。长期毒性尚未进行前瞻性评价。如果通过检查包括脑CT扫描记录的SCLC和CR患者可以推荐PCI，则缺乏将其应用于任何CR情况的数据。
A systematic review of the literature was carried out to determine the role of prophylactic cranial irradiation (PCI) in small cell lung cancer (SCLC) . To be eligible, full published trials needed to deal with SCLC and to have randomly assigned patients to receive PCI or not. Trials quality was assessed by two scores (Chalmers and ELCWP). Twelve randomised trials (1547 patients) were found to be eligible. Five evaluated the role of PCI in SCLC patients who had complete response (CR) after chemotherapy. Brain CT scan was done in the work-up in five studies and brain scintigraphy in six. Chalmers and ELCWP scores are well correlated (p < 0.001), with respective median scores of 32.6 and 38.8 %. This meta-analysis based on the available published data reveals a decrease of brain metastases incidence (hazard ratio (HR): 0.48; 95 % confidence interval (CI): 0.39 - 0.60) for all the studies and an improvement of survival (HR: 0.82; 95 % CI: 0.71 - 0.96) in patients in CR in favour of the PCI arm. Unfortunately, long-term neurotoxicity was not adequately described . PCI decreases brain metastases incidence and improves survival in CR SCLC patients but these effects were obtained in patients who had no systematic neuropsychological and brain imagery assessments. The long-term toxicity has not been prospectively evaluated. If PCI can be recommended in patients with SCLC and CR documented by a work-up including brain CT scan, data are lacking to generalise its use to any CR situations.
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影响因子：
5.3
作者：
Laplanche, A;Monnet, I;Arriagada, R
通讯作者：
Arriagada, R
DOI：
10.1016/0197-2456(81)90056-8
发表时间：
1981-01-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
CHALMERS, TC;SMITH, H;AMBROZ, A
通讯作者：
AMBROZ, A
影响因子：
3.9
作者：
Hochstenbag, MMH;Twijnstra, A;ten Velde, GPM
通讯作者：
ten Velde, GPM
影响因子：
158.5
作者：
Aupérin, A;Arriagada, R;Aisner, J
通讯作者：
Aisner, J
影响因子：
3.1
作者：
NIIRANEN, A;HOLSTI, P;SALMO, M
通讯作者：
SALMO, M