A Propensity-Matched Analysis of Outcomes of Patients with Clinical Stage I Non–Small Cell Lung Cancer Treated surgically or with stereotactic radiotherapy: A Meta-Analysis

Su, Wen Pang; Li, Han; Lv, Hui; Xu, Yong; Li, Zhenhua; Wang, Ming-Bo; Zhu, Yao; Su, Peng; Tian, Zi-Qiang; Zhang, Yue‐Feng

doi:10.1080/08941939.2017.1370519

Cited by 16 publications

(9 citation statements)

References 27 publications

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“…3/10 tratamento e desfechos nos estudos incluídos estão descritos na Tabela S1. A Tabela S2 mostra um resumo das meta-análises anteriores (10)(11)(12)(13)(14) da literatura e da presente meta-análise.…”

Section: Resultsunclassified

“…(9) Consequentemente, vários estudos e metaanálises comparando ambas as modalidades foram publicados. (10)(11)(12)(13)(14) No entanto, os estudos publicados anteriormente careciam de rigor metodológico, e alguns aspectos clínicos básicos estavam ausentes. Portanto, o presente estudo teve como objetivo realizar uma meta-análise de estudos comparando cirurgia e SBRT em pacientes com CPCNP em estágio inicial a fim de explorar aspectos clínicos e identificar possíveis diferenças para orientar futuros estudos relevantes.…”

Section: Introductionunclassified

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Stereotactic body radiotherapy versus surgery for early-stage non-small cell lung cancer: an updated meta-analysis involving 29,511 patients included in comparative studies

Viani

Gouveia²,

Yan

et al. 2022

J Bras Pneumol.

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Objective: To evaluate the efficacy of stereotactic body radiotherapy (SBRT) versus surgery for early-stage non-small cell lung cancer (NSCLC) by means of a meta-analysis of comparative studies. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology guidelines, searches were performed on PubMed, MEDLINE, Embase, and Cochrane Library for eligible studies. The meta-analysis compared the hazard ratios (HR) for overall survival (OS), cancer-specific survival (CSS), and local control (LC). Subgroup and meta-regression analyses evaluated the association of extent of surgical resection, study publication year, tumor staging, propensity score matching, proportion of chemotherapy use, and proportion of pathological lymph node involvement with CSS and OS. Results: Thirty studies involving 29,511 patients were included (surgery group: 17,146 patients and SBRT group: 12,365 patients). There was a significant difference in favor of surgery vs. SBRT in the 3-year OS (HR = 1.35; 95% CI: 1.22-1.44; I2 = 66%) and 3-year CSS (HR = 1.23; 95% CI: 1.09-1.37; I2 = 17%), but not in the 3-year LC (HR = 0.97; 95% CI: 0.93-1.08; I2 = 19%). In the subgroup analysis for OS, no significant difference between surgery and SBRT groups was observed in the T1N0M0 subgroup (HR = 1.26; 95% CI: 0.95-1.68; I2 = 0%). In subgroup analysis for CSS, no significant difference was detected between the sublobar resection subgroup and the SBRT group (HR = 1.21; 95% CI: 0.96-1.53; I2 = 16%). Conclusions: Surgery generally resulted in better 3-year OS and CSS than did SBRT; however, publication bias and heterogeneity may have influenced these findings. In contrast, SBRT produced LC results similar to those of surgery regardless of the extent of surgical resection. These findings may have important clinical implications for patients with comorbidities, advanced age, poor pulmonary reserve, and other factors that may contraindicate surgery. Keywords: Carcinoma, Non-Small-Cell Lung/surgery; Radiosurgery; Meta-analysis.

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Section: Resultsunclassified

Section: Introductionunclassified

Stereotactic body radiotherapy versus surgery for early-stage non-small cell lung cancer: an updated meta-analysis involving 29,511 patients included in comparative studies

Viani

Gouveia²,

Yan

et al. 2022

J Bras Pneumol.

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“…11–13 After a patient has been diagnosed with early-stage NSCLC, clinicians have to first determine the utility of any treatment 14–16 and then select the most appropriate therapy, both of which continue to be debated. 17,18 To determine the optimal treatment among different patient populations, a quantifiable means of comparing patients is needed in addition to stage and performance status. 19…”

Section: Discussionmentioning

confidence: 99%

Defining Optimal Comorbidity Measures for Patients With Early-Stage Non-small cell lung cancer Treated With Stereotactic Body Radiation Therapy

DeWees

Nikitas

Rehman

et al. 2019

Practical Radiation Oncology

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“…Several treatment strategies are used to treat such condition, including medication combination, [ 8 – 12 ] whole-brain radiotherapy (WBRT), [ 13 , 14 ] stereotactic radiosurgery, [ 15 – 17 ] and surgical resection. [ 18 – 20 ] As for the WBRT, the median survival time of patients with brain metastases from nonsmall cell lung cancer (BMNSCLC) often affect by their ages, the tumors’ performance score, numbers, and location of metastatic lesions.…”

Section: Introductionmentioning

confidence: 99%

Icotinib and whole-brain radiotherapy for the treatment in patients with brain metastases from EGFR-mutant nonsmall cell lung cancer

Jiang¹,

Zhang

Luo

et al. 2018

Medicine

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This study aimed to explore the effect and toxicity of icotinib and whole-brain radiotherapy (IWBRT) for the treatment of brain metastases from nonsmall cell lung cancer (BMNSCLC) with epidermal growth factor receptor (EGFR)-mutant among Chinese Han population.A total of 55 patients with EGFR-mutant BMNSCLC were included. They received orally icotinib (125 mg/tablet, 125 mg each time, 3 times daily) until disease progression. In addition, they also underwent whole-brain radiotherapy (3-Gy fractions once daily, 5 days weekly for a total dose of 30 Gy) in an attempt to extend their survival time. The outcomes consisted of complete response (CR), partial response (PR), stable disease (SD), progress disease (PD), overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). In addition, toxicity was also recorded in this study.The CR, PR, SD, PD, ORR, PFS, and OS were 38.2%, 52.8%, 5.4%, 3.6%, 90.1%, 12.5%, and 48.0% months, respectively. In addition, mild toxicity was observed in this study.This study demonstrated that IWBRT is efficacious with acceptable toxicity for patients with EGFR-mutant BMNSCLC among Chinese Han population.

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A Propensity-Matched Analysis of Outcomes of Patients with Clinical Stage I Non–Small Cell Lung Cancer Treated surgically or with stereotactic radiotherapy: A Meta-Analysis

Cited by 16 publications

References 27 publications

Stereotactic body radiotherapy versus surgery for early-stage non-small cell lung cancer: an updated meta-analysis involving 29,511 patients included in comparative studies

Stereotactic body radiotherapy versus surgery for early-stage non-small cell lung cancer: an updated meta-analysis involving 29,511 patients included in comparative studies

Defining Optimal Comorbidity Measures for Patients With Early-Stage Non-small cell lung cancer Treated With Stereotactic Body Radiation Therapy

Icotinib and whole-brain radiotherapy for the treatment in patients with brain metastases from EGFR-mutant nonsmall cell lung cancer

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