Efficacies of Different Postoperative Radiotherapy Techniques in Patients with N2 Non-small Cell Lung Cancer: a Meta-analysis

Overview

Journal Am J Transl Res

Specialty General Medicine

Date 2024 Dec 16

PMID 39678624

Authors

Binxi Yao

Haoxiang Zhang

Xi Liang

Tianhe Zhao

Jingnan Hu

Jianli Ge

Yan Han

Wenshu Wang

Wenzhong Xu

Jianming He

Affiliations

Soon will be listed here.

Abstract

Background: With clinical trials on the use of different modern precise radiotherapy techniques in the setting of postoperative radiotherapy (PORT) in N2 non-small cell lung cancer (NSCLC) accumulating, an updated meta-analysis was performed.

Methods: A literature search identified studies that investigated PORT versus non-PORT in N2 NSCLC patients. Overall survival (OS) and locoregional recurrence (LR) were employed. The hazard ratio (HR) and relative risk (RR) with 95% confidence interval (CI) were analyzed.

Results: Overall, 33 studies comprised 8653 patients in the PORT group and 12398 in the non-PORT group. The HR for OS was 0.95 [95% CI: 0.91-0.98, P: 0.0009]. HRs of studies employing conventional radiotherapy, 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) were 0.90 [95% CI: 0.78-1.04, P: 0.16], 0.82 [95% CI: 0.72-0.93, P: 0.002] and 0.77 [95% CI: 0.64-0.91, P: 0.003], respectively. All HRs favor the PORT group. The RR for LR was 0.56 [95% CI: 0.49-0.65, P<0.00001]. RRs of studies employing conventional radiotherapy, 3D-CRT and IMRT were 0.61 [95% CI: 0.50-0.75, P<0.00001], 0.58 [95% CI: 0.46-0.72, P<0.00001] and 0.58 [95% CI: 0.45-0.73, P<0.00001], respectively.

Conclusion: PORT using 3D-CRT or IMRT benefits patients with N2 NSCLC in terms of LR and OS. PORT using conventional radiotherapy significantly decreases LR while it does not significantly increase OS.

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