A SUVmax-based propensity matched analysis of stereotactic body radiotherapy versus surgery in stage I non-small cell lung cancer: unveiling the role of 18F-FDG PET/CT in clinical decision-making

Ye, L.; Xu, Fan; Shi, Shengjun; Zeng, Zhao‐Chong; Jin, Xing; Huang, Yapeng; Lu, Chuanjia; Gu, Jie; He, Jian

doi:10.1007/s12094-017-1819-7

Cited by 3 publications

(8 citation statements)

References 28 publications

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“…For DFS, RFS or PFS, we included twelve relative studies in our meta-analysis (15,18,21,22,24,25,30,31,37,44,45,47). Eight studies de ned DFS, RFS or PFS as the time from treatment procedure until tumor recurrence or death (15,18,21,22,31,44,45,47), showing superior outcomes after surgery (matched studies: HR, 0.60;95% CI, 0.46-0.79; P=0.000; Figure E3, B).…”

Section: Primary Analysis: Results Of Survival Outcomes Of Surgery Versus Sbrtmentioning

confidence: 99%

“…Eight studies de ned DFS, RFS or PFS as the time from treatment procedure until tumor recurrence or death (15,18,21,22,31,44,45,47), showing superior outcomes after surgery (matched studies: HR, 0.60;95% CI, 0.46-0.79; P=0.000; Figure E3, B). Three studies de ned RFS or PFS as the time from the rst day of diagnosis to the date of tumor recurrence (25,30,37), but the pooled outcome of matched studies demonstrated no signi cantly difference between SBRT and surgery (HR, 0.61;95% CI, 0.34-1.08; P=0.091; Figure E3, B).…”

Section: Primary Analysis: Results Of Survival Outcomes Of Surgery Versus Sbrtmentioning

confidence: 99%

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Stereotactic body radiation therapy versus surgery for patients with early-stage non–small cell lung cancer( ≤ 5cm): A systematic review and meta-analysis

Zhou

Wen

et al. 2021

Preprint

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Background: Stereotactic body radiation therapy (SBRT) is considered as the preferred treatment method for inoperable early-stage non-small cell lung cancer (NSCLC). However, there is still a debate on the efficacy of SBRT and surgery. This meta-analysis aimed to compare survival outcomes of SBRT and surgery for early-stage NSCLC (≤5cm).Methods: A systematic review and meta-analysis were performed to compare survival outcomes of surgery and SBRT. And the pooled analysis was conducted with STATA 14.0 software. Results: Thirty-nine comparative studies were included for systematic review and twenty-eight of which for quantitative analysis. Compared with SBRT, overall survival (OS) was superior after surgical resection, included lobectomy, sublobar resection, video-assisted thoracoscopic surgery, and thoracotomy, for patients with early-stage NSCLC (≤5cm). And the results of subgroup analysis remained the support of surgery except for the OS of operable matched cohorts and the one matched cohort of age ≥75. However, the HR of OS showed a reduction from patients with unspecific age, ≥65 to ≥75 years old and histopathologically confirmed NSCLC to clinical NSCLC. Although cancer-specific survival and local control was superior after surgery, the recurrence rate of tumors, locoregional control, distant control, and regional control of matched patients demonstrated no significantly different outcomes between SBRT and surgery for early-stage NSCLC.Conclusions: Results show that surgery has superior OS, CSS and local control compared to SBRT for early-stage NSCLC. There is still necessary to explore the survival difference between SBRT and surgery for patients with different characteristics by large-sample, long-term follow-up randomized clinical studies.

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Section: Primary Analysis: Results Of Survival Outcomes Of Surgery Versus Sbrtmentioning

confidence: 99%

Section: Primary Analysis: Results Of Survival Outcomes Of Surgery Versus Sbrtmentioning

confidence: 99%

Stereotactic body radiation therapy versus surgery for patients with early-stage non–small cell lung cancer( ≤ 5cm): A systematic review and meta-analysis

Zhou

Wen

et al. 2021

Preprint

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“…A total of 7,330 studies were identified from the databases, among which 54 were included in the full-text evaluation. Fifteen retrospective studies were included in this meta-analysis ( 11 , 12 , 15 - 27 ) ( Figure 1 ). All the included studies were of moderate quality at least.…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies reported OS ( 11 , 12 , 15 - 27 ). The pooled HR showed that surgery was associated with a significantly higher OS than SBRT (HR =1.81; 95% CI, 1.72–1.90; P=0.000; Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Surgery showed significantly better outcomes compared with SBRT (HR =2.25; 95% CI, 1.65–3.06; P=0.000; Figure 4A ). The other four studies ( 11 , 15 , 16 , 20 ) defined RFS as freedom from any tumour recurrence, and the pooled results showed that there was no significant difference between surgery and SBRT (HR =0.73; 95% CI, 0.34–1.60; P=0.434; Figure 4B ). According to the results of the sensitivity analysis, the pooled results are relatively stable and credible ( Table S2 ).…”

Section: Resultsmentioning

confidence: 99%

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Stereotactic body radiation therapy or surgery for stage I–II non-small cell lung cancer treatment?—outcomes of a meta-analysis

Zhang¹,

Shao²,

Tian³

et al. 2019

Transl. Cancer Res.

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Background Stereotactic body radiotherapy (SBRT) has been increasingly recognized as a favourable alternative to surgical resection for early-stage non-small cell lung cancer (NSCLC). Many retrospective analyses compared the efficacy of SBRT with that of surgery for NSCLC. However, the difference in efficacy between SBRT and surgery in patients with early-stage NSCLC remains unclear. Methods We searched PubMed, the Cochrane Library, EMBASE and the Chinese Biomedical Literature Database from inception to March 14, 2018, to identify studies comparing SBRT with surgery in the treatment of stage I/II NSCLC. STATA 12.0 software was used to perform the meta-analysis. Results A total of 15 studies that carried out propensity score matching (PSM) were included. In this meta-analysis, patients with SBRT had worse overall survival (OS) than those with surgery, but the analysis restricting studies to the same adjustment factors showed that the difference in OS gradually decreased with the increase in comparable matching characteristics between the two groups and that there was eventually no significant difference. Patients treated with SBRT achieved similar cause-specific survival (CSS), local control, regional control, loco-regional control, and distant control compared with surgery. In addition, a separate analysis of 6 studies that compared SBRT with lobectomy also showed that with the increase in comparable matching characteristics between surgery and SBRT, the OS differences gradually decreased, and there was eventually no significant difference. Conclusions In this study, we found more favourable OS for stage I/II NSCLC treated with surgery, but when there were increasing numbers of comparable matching characteristics between surgery and SBRT, the differences in the survival rate were reduced to the point that they were not significant. The CSS and recurrence (local, regional, or disseminated) differences between surgery and SBRT were also not significant. Therefore, SBRT has the potential to be an alternative to surgical treatment in patients with stage I/II NSCLC, but these findings need to be confirmed by large-sample, long-term follow-up randomized clinical studies.

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Chemotherapy with a TP Regimen in Combination with Stereotactic Radiotherapy Could Significantly Optimize the Clinical Efficacy of NSCLC Treatment

Chen

Wang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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The changes in lifestyle and bad living habits have a significant impact on the health of people, resulting in an increasing prevalence of lung cancer. The most prevalent kind of lung cancer is nonsmall cell lung cancer (NSCLC), which accounts for around 80% of all cases. Chemotherapy is a common treatment method in clinical practice with certain negative effects. The primary goal of this study is to investigate the clinical efficacy of stereotactic radiotherapy in combination with a docetaxel plus cisplatin (TP) chemotherapy regimen in patients with nonsmall cell lung cancer (NSCLC) and their impact on the levels of cytokeratin fragment 21-1 (CYFRA21-1) and metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in NSCLC patients. Eighty patients who were admitted to the hospital between November 2016 and November 2019 were recruited and assigned to receive either chemotherapy with a TP regimen (the control group) or chemotherapy with a TP regimen plus stereotactic radiotherapy (the observation group). The WHO response evaluation criteria (REC) for solid tumors were adopted to analyze short-term efficacy, and the Karnofsky performance status (KPS) score was used to assess the quality of life by recording adverse reactions in the blood system, kidney, gastrointestinal tract, bladder, nervous system, and heart. The levels of CYFRA21-1 and MALAT1 in serum before and after the treatment were determined and compared. As a result, the observation group showed higher total efficacy and MALAT1 level, better quality of life, and lower CYFRA21-1 level than the control group ( P < 0.05 ). Stereotactic radiotherapy plus TP regimen chemotherapy resulted in significantly better progression-free survival, overall survival, survival rate, and long-term prognosis versus chemotherapy alone. Moreover, combined therapy was associated with a lower incidence of hemoglobin reduction, gastrointestinal reaction, and renal impairment versus TP regimen chemotherapy ( P < 0.05 ). Therefore, we concluded that stereotactic radiotherapy plus chemotherapy with a TP regimen significantly optimizes the clinical efficacy of the NSCLC treatment.

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A SUVmax-based propensity matched analysis of stereotactic body radiotherapy versus surgery in stage I non-small cell lung cancer: unveiling the role of 18F-FDG PET/CT in clinical decision-making

Abstract: The study found a superior PFS after surgery while OS and LRC did not differ between SBRT and surgery. Surgery should be recommended for tumor of high SUV.

Cited by 3 publications

References 28 publications

Stereotactic body radiation therapy versus surgery for patients with early-stage non–small cell lung cancer( ≤ 5cm): A systematic review and meta-analysis

Stereotactic body radiation therapy versus surgery for patients with early-stage non–small cell lung cancer( ≤ 5cm): A systematic review and meta-analysis

Stereotactic body radiation therapy or surgery for stage I–II non-small cell lung cancer treatment?—outcomes of a meta-analysis

Chemotherapy with a TP Regimen in Combination with Stereotactic Radiotherapy Could Significantly Optimize the Clinical Efficacy of NSCLC Treatment

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