Abstract：
OBJECTIVE: Approximately 55% of patients diagnosed with primary or metastatic cancer endure pain directly attributable to the disease. Consequently, it becomes imperative to address pain management through a comparative analysis of stereotactic radiotherapy (SRT) and conventional radiation therapy (CRT), especially in light of the less efficacious improvement achieved solely through pharmacological interventions.
METHODS: A systematic exploration was undertaken on PubMed, the Cochrane Library, and Elsevier\'s ScienceDirect databases to identify studies that compare Stereotactic Radiotherapy to Conventional radiation therapy for pain management in individuals with metastatic bone cancer. The analyses were executed utilizing the random-effects model.
RESULTS: A cohort of 1152 participants with metastatic bone cancer was analyzed, demonstrating significantly higher complete pain relief in the Stereotactic Radiotherapy group during both early and late follow-up (RR: 1.61; 95% CI: 1.17, 2.23, p-value: 0.004; I2: 0%). Stereotactic Radiotherapy also showed a non-significant increase in the incidence of partial pain relief (RR: 1.07; 95% CI: 0.85, 1.34, p-value: 0.56; I2: 18%). Furthermore, Stereotactic Radiotherapy was associated with a significantly reduced risk of stationary pain throughout follow-up (RR: 0.61; 95%CI: 0.48, 0.76, p-value: <0.0001; I2: 0. The incidence of progressive pain was non-significantly reduced with Stereotactic Radiotherapy during both early and late follow-up (RR: 0.77; 95% CI: 0.50, 1.17, p-value: 0.22; I2: 0%). Secondary outcomes exhibited a non-significant trend favoring Stereotactic Radiotherapy for dysphagia, esophagitis, pain, and radiodermatitis, while a non-significant increase was observed for nausea, fatigue, and vertebral compression fracture.
CONCLUSIONS: In summary, stereotactic radiation therapy (SRT) has improved in achieving complete pain relief while exhibiting a decreased probability of delivering stationary pain compared to conventional radiation therapy (CRT). Nevertheless, it is crucial in future research to address a noteworthy limitation, specifically, the risk of vertebral compression fracture.
METHODS: A systematic exploration was undertaken on PubMed, the Cochrane Library, and Elsevier\'s ScienceDirect databases to identify studies that compare Stereotactic Radiotherapy to Conventional radiation therapy for pain management in individuals with metastatic bone cancer. The analyses were executed utilizing the random-effects model.
RESULTS: A cohort of 1152 participants with metastatic bone cancer was analyzed, demonstrating significantly higher complete pain relief in the Stereotactic Radiotherapy group during both early and late follow-up (RR: 1.61; 95% CI: 1.17, 2.23, p-value: 0.004; I2: 0%). Stereotactic Radiotherapy also showed a non-significant increase in the incidence of partial pain relief (RR: 1.07; 95% CI: 0.85, 1.34, p-value: 0.56; I2: 18%). Furthermore, Stereotactic Radiotherapy was associated with a significantly reduced risk of stationary pain throughout follow-up (RR: 0.61; 95%CI: 0.48, 0.76, p-value: <0.0001; I2: 0. The incidence of progressive pain was non-significantly reduced with Stereotactic Radiotherapy during both early and late follow-up (RR: 0.77; 95% CI: 0.50, 1.17, p-value: 0.22; I2: 0%). Secondary outcomes exhibited a non-significant trend favoring Stereotactic Radiotherapy for dysphagia, esophagitis, pain, and radiodermatitis, while a non-significant increase was observed for nausea, fatigue, and vertebral compression fracture.
CONCLUSIONS: In summary, stereotactic radiation therapy (SRT) has improved in achieving complete pain relief while exhibiting a decreased probability of delivering stationary pain compared to conventional radiation therapy (CRT). Nevertheless, it is crucial in future research to address a noteworthy limitation, specifically, the risk of vertebral compression fracture.
摘要：
目的：大约55%被诊断为原发性或转移性癌症的患者忍受直接归因于疾病的疼痛。因此,通过立体定向放射治疗（SRT）和常规放射治疗（CRT）的比较分析来解决疼痛管理变得势在必行，特别是考虑到仅通过药物干预实现的效果较差。
方法：在PubMed上进行了系统的探索，Cochrane图书馆,和Elsevier的ScienceDirect数据库，以确定将立体定向放射治疗与常规放射治疗对转移性骨癌患者疼痛管理进行比较的研究。利用随机效应模型进行分析。
结果：分析了1152名转移性骨癌患者的队列，在早期和晚期随访期间,立体定向放疗组的疼痛完全缓解率显著提高(RR:1.61;95%CI:1.17,2.23,p值:0.004;I2:0%).立体定向放射治疗也显示部分疼痛缓解的发生率没有显着增加（RR：1.07；95％CI：0.85，1.34，p值：0.56；I2：18％）。此外，在整个随访期间，立体定向放疗与固定疼痛风险显著降低相关(RR:0.61;95CI:0.48,0.76,p值:<0.0001;I2:0。在早期和晚期随访期间，立体定向放射治疗的进行性疼痛发生率均未明显降低（RR：0.77；95％CI：0.50，1.17，p值：0.22；I2：0％）。次要结局表现出有利于吞咽困难的立体定向放射治疗的非显著趋势，食管炎,疼痛,和放射性皮炎，虽然观察到恶心没有显着增加，疲劳,和椎体压缩性骨折。
结论：总之，与常规放射治疗(CRT)相比,立体定向放射治疗(SRT)在实现完全缓解疼痛方面有所改进,同时表现出减少持续性疼痛的可能性.然而，在未来的研究中，解决一个值得注意的局限性是至关重要的，具体来说,椎体压缩性骨折的风险。
方法：在PubMed上进行了系统的探索，Cochrane图书馆,和Elsevier的ScienceDirect数据库，以确定将立体定向放射治疗与常规放射治疗对转移性骨癌患者疼痛管理进行比较的研究。利用随机效应模型进行分析。
结果：分析了1152名转移性骨癌患者的队列，在早期和晚期随访期间,立体定向放疗组的疼痛完全缓解率显著提高(RR:1.61;95%CI:1.17,2.23,p值:0.004;I2:0%).立体定向放射治疗也显示部分疼痛缓解的发生率没有显着增加（RR：1.07；95％CI：0.85，1.34，p值：0.56；I2：18％）。此外，在整个随访期间，立体定向放疗与固定疼痛风险显著降低相关(RR:0.61;95CI:0.48,0.76,p值:<0.0001;I2:0。在早期和晚期随访期间，立体定向放射治疗的进行性疼痛发生率均未明显降低（RR：0.77；95％CI：0.50，1.17，p值：0.22；I2：0％）。次要结局表现出有利于吞咽困难的立体定向放射治疗的非显著趋势，食管炎,疼痛,和放射性皮炎，虽然观察到恶心没有显着增加，疲劳,和椎体压缩性骨折。
结论：总之，与常规放射治疗(CRT)相比,立体定向放射治疗(SRT)在实现完全缓解疼痛方面有所改进,同时表现出减少持续性疼痛的可能性.然而，在未来的研究中，解决一个值得注意的局限性是至关重要的，具体来说,椎体压缩性骨折的风险。
