Abstract：
There are limited data available on clinical outcomes after stereotactic body radiation therapy (SBRT) for nonspinal bone metastases. We performed a systematic review and meta-analysis to characterize local control (LC), overall survival (OS), pain response rates, and toxicity after SBRT. The primary outcomes were 1-year LC, incidence of acute and late grade 3 to 5 toxicities, and overall pain response rate at 3 months. The secondary outcome was 1-year OS. The Newcastle-Ottawa scale was used for assessment of study bias, with a median score of 5 for included studies (range, 4-8). Weighted random-effects meta-analyses were conducted to estimate effect sizes. We identified 528 patients with 597 nonspinal bone lesions in 9 studies (1 prospective study and 8 retrospective observational studies) treated with SBRT. The estimated 1-year LC rate was 94.6% (95% CI, 87.0%-99.0%). The estimated 3-month combined partial and complete pain response rate after SBRT was 87.7% (95% CI, 55.1%-100.0%). The estimated combined acute and late grade 3 to 5 toxicity rate was 0.5% (95% CI, 0%-5.0%), with an estimated pathologic fracture rate of 3.1% (95% CI, 0.2%-9.1%). The estimated 1-year OS rate was 71.0% (95% CI, 51.7%-87.0%). SBRT results in excellent LC and palliation of symptoms with minimal related toxicity. Prospective investigations are warranted to further characterize long-term outcomes of SBRT for patients with nonspinal bone metastases.
摘要：
背景：关于立体定向全身放疗（SBRT）治疗非脊柱骨转移的临床结果的可用数据有限。我们进行了系统评价和荟萃分析，以表征局部控制(LC)，总生存期（OS），疼痛反应率，和SBRT后的毒性。
方法：主要结局是1年LC，急性和晚期3-5级毒性的发生率，和3个月时的总体疼痛反应率。次要结果是1年OS。纽卡斯尔-渥太华量表用于评估研究偏倚，纳入研究的中位数得分为5（范围：4-8）。进行加权随机效应荟萃分析以估计效应大小。
结果：我们在9项研究中确定了528例患者，597例非脊柱骨病变，1个前瞻性观察和8个回顾性观察，用SBRT治疗。估计的1年LC率为94.6%(95%CI:87.0-99.0%)。SBRT后3个月的部分和完全疼痛综合反应率为87.7%(95%CI:55.1-100.0%)。估计的急性和晚期3-5级联合毒性率为0.5％（95％CI：0-5.0％），估计的病理性骨折率为3.1％（95％CI：0.2-9.1％）。估计1年OS率为71.0%(95%CI:51.7-87.0%)。
结论：SBRT可导致出色的LC和症状缓解，相关毒性最小。有必要进行前瞻性研究，以进一步表征非脊柱骨转移患者SBRT的长期结局。
方法：主要结局是1年LC，急性和晚期3-5级毒性的发生率，和3个月时的总体疼痛反应率。次要结果是1年OS。纽卡斯尔-渥太华量表用于评估研究偏倚，纳入研究的中位数得分为5
结果：我们在9项研究中确定了528例患者，597例非脊柱骨病变，1个前瞻性观察和8个回顾性观察，用SBRT治疗。估计的1年LC率为94.6%(95%CI:87.0-99.0%)。SBRT后3个月的部分和完全疼痛综合反应率为87.7%(95%CI:55.1-100.0%)。估计的急性和晚期3-5级联合毒性率为0.5％（95％CI：0-5.0％），估计的病理性骨折率为3.1％（95％CI：0.2-9.1％）。估计1年OS率为71.0%(95%CI:51.7-87.0%)。
结论：SBRT可导致出色的LC和症状缓解，相关毒性最小。有必要进行前瞻性研究，以进一步表征非脊柱骨转移患者SBRT的长期结局。
