目的:进行了系统评价,以研究不同种族和不同原发灶的同步脑转移(sBM)的发生率和原发灶的差异。
方法:遵循PRISMA2020指南,使用PubMed和Ovid数据库搜索2000年1月至2023年1月的出版物,搜索词包括“脑转移”的组合,\"\"种族,\"\"种族,“和”发生率。“三名独立审核员筛选纳入标准,包括明确报告原发性癌症部位的研究,患者人口统计学包括种族,和同步BM(sBM)发病率。
结果:在806篇文章中,10项研究主要由来自美国的成年患者组成,最终纳入数据分析。在美洲印第安人/阿拉斯加本地患者中观察到较高的sBM发生率(p<0.001),结直肠(p=0.015),和食管癌(p=0.024)以及亚洲或太平洋岛民原发性胃癌(p<0.001),甲状腺(p=0.006),和肺癌/支气管癌(p<0.001),但白人患者中恶性黑色素瘤的比例更高(p<0.001)。与白人患者相比,黑人患者在乳腺癌中sBM发生率较高(OR=1.27,p=0.01),但在肾癌(OR=0.46,p<0.001)和食道癌(OR=0.31,p=0.005)中sBM发生率较低。美国印第安人/阿拉斯加本地患者的sBM可能性较白人食管癌患者高(OR=3.78,p=0.004)。
结论:这些发现揭示了由不同原发癌起源引起的sBM发病率的几个比较种族差异,强调需要进一步研究来解释这些变化。确定导致这些差异的因素有可能根据癌症类型促进肿瘤护理的更大公平性。
OBJECTIVE: A systematic
review was conducted to investigate differences in incidence and primary origin of synchronous brain
metastasis (sBM) in varying racial groups with different primary cancers.
METHODS: Adhering to PRISMA 2020 guidelines a search was conducted using PubMed and Ovid databases for publications from January 2000 to January 2023, with search terms including combinations of \"brain
metastasis,\" \"race,\" \"ethnicity,\" and \"incidence.\" Three independent reviewers screened for inclusion criteria encompassing studies clearly reporting primary cancer sites, patient demographics including race, and synchronous BM (sBM) incidence.
RESULTS: Of 806 articles, 10 studies comprised of mainly adult patients from the United States met final inclusion for data analysis. Higher sBM incidence proportions were observed in American Indian/Alaska native patients for primary breast (p < 0.001), colorectal (p = 0.015), and esophageal cancers (p = 0.024) as well as in Asian or Pacific islanders for primary stomach (p < 0.001), thyroid (p = 0.006), and lung/bronchus cancers (p < 0.001) yet higher proportions in White patients for malignant melanoma (p < 0.001). Compared to White patients, Black patients had higher sBM incidence likelihood in breast cancer (OR = 1.27, p = 0.01) but lower likelihood in renal (OR = 0.46, p < 0.001) and esophageal cancers (OR = 0.31, p = 0.005). American Indian/Alaska native patients had a higher sBM likelihood (OR = 3.78, p = 0.004) relative to White patients in esophageal cancer.
CONCLUSIONS: These findings reveal several comparative racial differences in sBM incidence arising from different primary cancer origins, underscoring a need for further research to explain these variations. Identifying the factors contributing to these disparities holds the potential to promote greater equity in oncological care according to cancer type.