Gustavo A Viani1, Caio V Arruda2, Ligia I De Fendi3. 1. Ribeirão Preto Medical School, University of São Paulo. 2. Bioscience Institute of University of State from Sao Paulo (UNESP), Botucatu, SP, Brazil. 3. Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto.
Abstract
OBJECTIVE: The effectiveness and safety of reirradiation with stereotactic ablative radiotherapy (re-SABR) in patients with recurrence after a previous course of radiation are limited to small series. We carried out a meta-analysis to summarize existing data and identify trends in overall survival (OS), local control (LC), and toxicity after re-SABR in patients with recurrence of lung cancer. MATERIALS AND METHODS: Eligible studies were identified on Medline, Embase, the Cochrane Library, and the proceedings of annual meetings through June 2019. We followed the PRISMA and MOOSE guidelines. A meta-regression analysis was carried out to assess whether there is a relationship between moderator variables and outcomes. A P-value<0.05 was considered significant. RESULTS: Twenty observational studies with a total of 595 patients treated were included. The 2-year OS and LC were 0.54 (95% confidence interval [CI]: 0.48-0.61) and 0.73 (95% CI: 0.66-0.80), respectively. The rate of any toxicity grade ≥3 was 0.098 (95% CI: 0.06-13.6), with 9 grade 5 toxicity (1.5%). In the meta-regression, the re-SABR dose (P=0.028), tumor size (P=0.031), and time to recurrence (P=0.018) showed an association with survival. For LC, the re-SABR dose (P=0.034) and tumor size (P=0.040) were statistically significant. Any toxicity grade ≥3 showed a relationship with the cumulative dose (P=0.024). Cumulative dose ≤145 versus >145 Gy2 had 3% versus 15% (P=0.013) of any grade ≥3 toxicity. CONCLUSIONS: Re-SABR produces satisfactory LC and OS rates with an acceptable rate of toxicity. The balancing between the re-SABR dose and the tumor location has the potential to reduce severe and fatal toxicity.
OBJECTIVE: The effectiveness and safety of reirradiation with stereotactic ablative radiotherapy (re-SABR) in patients with recurrence after a previous course of radiation are limited to small series. We carried out a meta-analysis to summarize existing data and identify trends in overall survival (OS), local control (LC), and toxicity after re-SABR in patients with recurrence of lung cancer. MATERIALS AND METHODS: Eligible studies were identified on Medline, Embase, the Cochrane Library, and the proceedings of annual meetings through June 2019. We followed the PRISMA and MOOSE guidelines. A meta-regression analysis was carried out to assess whether there is a relationship between moderator variables and outcomes. A P-value<0.05 was considered significant. RESULTS: Twenty observational studies with a total of 595 patients treated were included. The 2-year OS and LC were 0.54 (95% confidence interval [CI]: 0.48-0.61) and 0.73 (95% CI: 0.66-0.80), respectively. The rate of any toxicity grade ≥3 was 0.098 (95% CI: 0.06-13.6), with 9 grade 5 toxicity (1.5%). In the meta-regression, the re-SABR dose (P=0.028), tumor size (P=0.031), and time to recurrence (P=0.018) showed an association with survival. For LC, the re-SABR dose (P=0.034) and tumor size (P=0.040) were statistically significant. Any toxicity grade ≥3 showed a relationship with the cumulative dose (P=0.024). Cumulative dose ≤145 versus >145 Gy2 had 3% versus 15% (P=0.013) of any grade ≥3 toxicity. CONCLUSIONS: Re-SABR produces satisfactory LC and OS rates with an acceptable rate of toxicity. The balancing between the re-SABR dose and the tumor location has the potential to reduce severe and fatal toxicity.
Authors: A G Morganti; G Macchia; F Deodato; D Pezzulla; S Cilla; M Ferro; C Romano; P Bonome; M Buwenge; A Zamagni; L Strigari; V Valentini Journal: Clin Transl Oncol Date: 2022-01-04 Impact factor: 3.405
Authors: Brane Grambozov; Markus Stana; Bernhard Kaiser; Josef Karner; Sabine Gerum; Elvis Ruznic; Barbara Zellinger; Raphaela Moosbrugger; Michael Studnicka; Gerd Fastner; Felix Sedlmayer; Franz Zehentmayr Journal: Cancers (Basel) Date: 2022-01-23 Impact factor: 6.639