未经批准:IIIAN2期非小细胞肺癌(NSCLC)的治疗通常包括联合化疗,放射治疗,和手术,但最佳测序尚未确定。手术后的局部复发率仍然很高,术后放疗(PORT)在N2疾病中的作用尚不清楚。这项荟萃分析旨在确定PORT是否为接受完全手术切除并接受辅助化疗的IIIAN2期疾病患者提供了超出观察的额外生存优势。
UNASSIGNED:纳入了所有比较IIIA期N2非小细胞肺癌根治性手术切除后辅助化疗和PORT与单独辅助化疗的研究。根据MOOSE(荟萃分析和观察性研究的系统评价)指南,使用随机效应建模进行荟萃分析。亚组分析,异质性,并评估了偏见的风险,使用meta回归来确定患者和肿瘤特征对结局的影响。
UNASSIGNED:十项研究,汇集了18,077名患者的数据集(5453PORT,包括12,624个港口)。PORT显著提高了1年时的总生存期(OS)和无病生存期(DFS)(OS:风险比[HR],0.768;DFS:HR,0.733),3年(操作系统:HR,0.914;DFS:HR,0.732),和5年(操作系统:HR,0.898;DFS:HR,0.735,所有P<.0001)。这些效应与特定患者或肿瘤特征无关。
UNASSIGNED:本研究表明,辅助化疗后添加PORT对DFS和OS有显著益处。我们主张在进行专科多学科评估和全面讨论治疗的益处和风险后,对此类患者考虑使用PORT。
UNASSIGNED: Treatment for stage IIIA N2 non-small cell lung cancer (NSCLC) typically involves a combination of chemotherapy, radiotherapy, and surgery, but the optimal sequencing is not determined. Local recurrence rates following surgery remain high, and the role of postoperative radiotherapy (PORT) in N2 disease is unclear. This meta-analysis aims to determine whether PORT provides additional survival advantage beyond observation for patients with stage IIIA N2 disease who have undergone complete surgical resection and received adjuvant chemotherapy.
UNASSIGNED: All studies comparing adjuvant chemotherapy and PORT versus adjuvant chemotherapy alone after curative surgical resection for stage IIIA N2 NSCLC were included. Meta-analysis was performed using random effects modelling in accordance with MOOSE (Meta-Analyses and Systematic Reviews of Observational Studies) guidelines. Subgroup analysis, heterogeneity, and risk of bias were assessed, with meta-regression to determine the effects of patient and tumor characteristics on outcomes.
UNASSIGNED: Ten studies with a pooled dataset of 18,077 patients (5453 PORT, 12,624 no PORT) were included. PORT significantly improved both overall survival (OS) and disease-free survival (DFS) at 1 year (OS: hazard ratio [HR], 0.768; DFS: HR, 0.733), 3 years (OS: HR, 0.914; DFS: HR, 0.732), and 5 years (OS: HR, 0.898; DFS: HR, 0.735, all P < .0001). These effects were independent of specific patient or tumor characteristics.
UNASSIGNED: This study demonstrates a significant DFS and OS benefit from the addition of PORT following adjuvant chemotherapy. We advocate the consideration of PORT for such patients following specialist multidisciplinary assessment and comprehensive discussion of the benefits and risks of treatment.