Alexander Chi1, Haiquan Chen2, Sijin Wen3, Haijuan Yan4, Zhongxing Liao5. 1. Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, China. Electronic address: achiaz2010@gmail.com. 2. Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, China. 3. Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, USA. Electronic address: siwen@hsc.wvu.edu. 4. Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, USA. 5. Department of Radiation Oncology, MD Anderson Cancer Center, Houston, USA.
Abstract
PURPOSE: To assess hypo-fractionated particle beam therapy (PBT)'s efficacy relative to that of photon stereotactic body radiotherapy (SBRT) for early stage (ES) non-small cell lung cancer (NSCLC). METHODS: Eligible studies were identified through extensive searches of the PubMed, Medline, Google-scholar, and Cochrane library databases from 2000 to 2016. Original English publications of ES NSCLC were included. A meta-analysis was performed to compare the survival outcome, toxicity profile, and patterns of failure following each treatment. RESULTS: 72 SBRT studies and 9 hypo-fractionated PBT studies (mostly single-arm) were included. PBT was associated with improved overall survival (OS; p=0.005) and progression-free survival (PFS; p=0.01) in the univariate meta-analysis. The OS benefit did not reach its statistical significance after inclusion of operability into the final multivariate meta-analysis (p=0.11); while the 3-year local control (LC) still favored PBT (p=0.03). CONCLUSION: Although hypo-fractionated PBT may lead to additional clinical benefit when compared with photon SBRT, no statistically significant survival benefit from PBT over SBRT was observed in the treatment of ES NSCLC in this hypothesis-generating meta-analysis after adjusting for potential confounding variables.
PURPOSE: To assess hypo-fractionated particle beam therapy (PBT)'s efficacy relative to that of photon stereotactic body radiotherapy (SBRT) for early stage (ES) non-small cell lung cancer (NSCLC). METHODS: Eligible studies were identified through extensive searches of the PubMed, Medline, Google-scholar, and Cochrane library databases from 2000 to 2016. Original English publications of ES NSCLC were included. A meta-analysis was performed to compare the survival outcome, toxicity profile, and patterns of failure following each treatment. RESULTS: 72 SBRT studies and 9 hypo-fractionated PBT studies (mostly single-arm) were included. PBT was associated with improved overall survival (OS; p=0.005) and progression-free survival (PFS; p=0.01) in the univariate meta-analysis. The OS benefit did not reach its statistical significance after inclusion of operability into the final multivariate meta-analysis (p=0.11); while the 3-year local control (LC) still favored PBT (p=0.03). CONCLUSION: Although hypo-fractionated PBT may lead to additional clinical benefit when compared with photon SBRT, no statistically significant survival benefit from PBT over SBRT was observed in the treatment of ES NSCLC in this hypothesis-generating meta-analysis after adjusting for potential confounding variables.
Authors: Alexander V Louie; Cornelis J A Haasbeek; Sahar Mokhles; George B Rodrigues; Kevin L Stephans; Frank J Lagerwaard; David A Palma; Gregory M M Videtic; Andrew Warner; Johanna J M Takkenberg; Chandana A Reddy; Alex P W M Maat; Neil M Woody; Ben J Slotman; Suresh Senan Journal: Int J Radiat Oncol Biol Phys Date: 2015-05-09 Impact factor: 7.038
Authors: Angela van Baardwijk; Wolfgang A Tomé; Wouter van Elmpt; Søren M Bentzen; Bart Reymen; Rinus Wanders; Ruud Houben; Michel Ollers; Philippe Lambin; Dirk De Ruysscher Journal: Radiother Oncol Date: 2012-10-12 Impact factor: 6.280
Authors: M Scorsetti; P Navarria; A Facoetti; P Lattuada; G Urso; A Mirandola; G M Ferraroli; M Alloisio; G Ravasi Journal: Anticancer Res Date: 2007 Sep-Oct Impact factor: 2.480
Authors: Charles C Vu; Robert Matthews; Bong Kim; Dinko Franceschi; Thomas V Bilfinger; William H Moore Journal: Nucl Med Commun Date: 2013-10 Impact factor: 1.690