背景:立体定向身体放射疗法(SBRT)作为来自各种来源的肿瘤的肝脏寡转移的局部有效治疗方法的作用已得到充分确立。我们研究了机器人SBRT(rSBRT)治疗对肝脏病变的寡转移患者的作用。
方法:本综述是根据系统评价和荟萃分析陈述的首选报告项目进行的。PubMed和Scopus数据库由两名关于机器人rSBRT用于肝转移的独立研究人员访问,2023年10月3日
结果:总计,15项研究,包括646例接受rSBRT的847个病变,包括在我们的系统审查中。rSBRT后完全缓解(CR)达到40.5%(95%CI,36.66-44.46%),部分缓解(PR)为19.01%(95%CI,16.07-22.33%),而14.38%(95%CI,11.8~17.41%)的患者记录疾病稳定(SD),13.22%(95%CI,10.74~16.17%)的患者记录疾病进展(PD).12个月和24个月的无进展生存率(PFS)估计为61.49%(95%CI,57.01-65.78%)和32.55%(95%CI,28.47-36.92%),分别,而12个月和24个月的总生存率(OS)估计为58.59%(95%CI,53.67-63.33%)和44.19%(95%CI,39.38-49.12%),分别。1级毒性报告为13.81%(95%CI,11.01-17.18%),2级毒性为5.57%(95%CI,3.82-8.01%),和3级毒性在2.27%(955CI,1.22-4.07%)的纳入患者中。
结论:rSBRT代表了一种有希望的方法,可以在很大比例的患者中实现局部控制,毒性最小。需要进一步的研究来评估rSBRT在转移性肝脏病变管理中的作用。
BACKGROUND: The role of stereotactic body radiation therapy (SBRT) as a locally effective therapeutic approach for liver oligometastases from tumors of various origin is well established. We investigated the role of robotic SBRT (rSBRT) treatment on oligometastatic patients with liver lesions.
METHODS: This
review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The PubMed and Scopus databases were accessed by two independent investigators concerning robotic rSBRT for liver metastases, up to 3 October 2023.
RESULTS: In total, 15 studies, including 646 patients with 847 lesions that underwent rSBRT, were included in our systematic
review. Complete response (CR) after rSBRT was achieved in 40.5% (95% CI, 36.66-44.46%), partial response (PR) in 19.01% (95% CI, 16.07-22.33%), whereas stable disease (SD) was recorded in 14.38% (95% CI, 11.8-17.41%) and progressive disease (PD) in 13.22% (95% CI, 10.74-16.17%) of patients. Progression-free survival (PFS) rates at 12 and 24 months were estimated at 61.49% (95% CI, 57.01-65.78%) and 32.55% (95% CI, 28.47-36.92%), respectively, while the overall survival (OS) rates at 12 and 24 months were estimated at 58.59% (95% CI, 53.67-63.33%) and 44.19% (95% CI, 39.38-49.12%), respectively. Grade 1 toxicity was reported in 13.81% (95% CI, 11.01-17.18%), Grade 2 toxicity in 5.57% (95% CI, 3.82-8.01%), and Grade 3 toxicity in 2.27% (955 CI, 1.22-4.07%) of included patients.
CONCLUSIONS: rSBRT represents a promising method achieving local control with minimal toxicity in a significant proportion of patients. Further studies are needed to evaluate the role of rSBRT in the management of metastatic liver lesions.