Prophylactic cranial irradiation in patients with resected small‐cell lung cancer: A systematic review and meta‐analysis
Abstract Prophylactic cranial irradiation (PCI) was recommended for limited‐stage small‐cell lung cancer (SCLC) patients with complete or partial response to primary chemoradiotherapy. But it is still controversial regarding its role in SCLC patients who have had radical resection. This meta‐analysi...
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| Format: | Article |
| Language: | English |
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Wiley
2024-11-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.15463 |
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| author | Haoning Peng Jianqi Hao Bo Dong Minqi Chen Zongyuan Li Cong Chen Lunxu Liu |
| author_facet | Haoning Peng Jianqi Hao Bo Dong Minqi Chen Zongyuan Li Cong Chen Lunxu Liu |
| author_sort | Haoning Peng |
| collection | DOAJ |
| description | Abstract Prophylactic cranial irradiation (PCI) was recommended for limited‐stage small‐cell lung cancer (SCLC) patients with complete or partial response to primary chemoradiotherapy. But it is still controversial regarding its role in SCLC patients who have had radical resection. This meta‐analysis aims to evaluate the efficacy of PCI in resected SCLC patients. We searched PubMed, EMBASE, Web of Science, CENTRAl, and ClinicalTrials for controlled trials and cohort studies regarding PCI in postoperative SCLC patients. The correlation between PCI and post‐operative outcomes in SCLC patients, including survival and brain metastasis rate (BMR), was examined using hazard ratios (HRs) and risk ratios with corresponding 95% confidence intervals. Quality of studies was assessed by the Newcastle–Ottawa Scale (NOS), and publication bias was assessed by Begg's test. Meta‐analysis of eight studies with 2688 patients in total showed PCI was associated with improved overall survival (OS) for resected SCLC (HR: 0.65, 95% CI: 0.57–0.75, p < 0.01). In addition, subgroup analysis on three studies including 923 patients confirmed the protective role of postoperative PCI in N0 SCLC patients (HR: 0.79, 95% CI: 0.61–0.97, p < 0.05). There was also a significant reduction in BMR in the PCI group pooled from six studies (HR: 0.58, 95% CI: 0.40–0.85, p < 0.01). The use of PCI delayed brain recurrence and improved OS in patients with resected, stage I‐III SCLC. Importantly, patients with N0 SCLC can also benefit from postoperative PCI. In future studies, PCI's role in patients with resected N0 SCLC at different T stage may need to be explored. |
| format | Article |
| id | doaj-art-efa130c76bd74b1eb09633e027194fea |
| institution | OA Journals |
| issn | 1759-7706 1759-7714 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj-art-efa130c76bd74b1eb09633e027194fea2025-08-20T02:13:59ZengWileyThoracic Cancer1759-77061759-77142024-11-0115322309231810.1111/1759-7714.15463Prophylactic cranial irradiation in patients with resected small‐cell lung cancer: A systematic review and meta‐analysisHaoning Peng0Jianqi Hao1Bo Dong2Minqi Chen3Zongyuan Li4Cong Chen5Lunxu Liu6Department of Thoracic Surgery West China Hospital, Sichuan University Chengdu ChinaDepartment of Thoracic Surgery West China Hospital, Sichuan University Chengdu ChinaDepartment of Thoracic Surgery West China Hospital, Sichuan University Chengdu ChinaDepartment of Thoracic Surgery West China Hospital, Sichuan University Chengdu ChinaDepartment of Thoracic Surgery West China Hospital, Sichuan University Chengdu ChinaDepartment of Thoracic Surgery West China Hospital, Sichuan University Chengdu ChinaDepartment of Thoracic Surgery West China Hospital, Sichuan University Chengdu ChinaAbstract Prophylactic cranial irradiation (PCI) was recommended for limited‐stage small‐cell lung cancer (SCLC) patients with complete or partial response to primary chemoradiotherapy. But it is still controversial regarding its role in SCLC patients who have had radical resection. This meta‐analysis aims to evaluate the efficacy of PCI in resected SCLC patients. We searched PubMed, EMBASE, Web of Science, CENTRAl, and ClinicalTrials for controlled trials and cohort studies regarding PCI in postoperative SCLC patients. The correlation between PCI and post‐operative outcomes in SCLC patients, including survival and brain metastasis rate (BMR), was examined using hazard ratios (HRs) and risk ratios with corresponding 95% confidence intervals. Quality of studies was assessed by the Newcastle–Ottawa Scale (NOS), and publication bias was assessed by Begg's test. Meta‐analysis of eight studies with 2688 patients in total showed PCI was associated with improved overall survival (OS) for resected SCLC (HR: 0.65, 95% CI: 0.57–0.75, p < 0.01). In addition, subgroup analysis on three studies including 923 patients confirmed the protective role of postoperative PCI in N0 SCLC patients (HR: 0.79, 95% CI: 0.61–0.97, p < 0.05). There was also a significant reduction in BMR in the PCI group pooled from six studies (HR: 0.58, 95% CI: 0.40–0.85, p < 0.01). The use of PCI delayed brain recurrence and improved OS in patients with resected, stage I‐III SCLC. Importantly, patients with N0 SCLC can also benefit from postoperative PCI. In future studies, PCI's role in patients with resected N0 SCLC at different T stage may need to be explored.https://doi.org/10.1111/1759-7714.15463cranial irradiationsmall‐cell lung carcinomathoracic surgery |
| spellingShingle | Haoning Peng Jianqi Hao Bo Dong Minqi Chen Zongyuan Li Cong Chen Lunxu Liu Prophylactic cranial irradiation in patients with resected small‐cell lung cancer: A systematic review and meta‐analysis Thoracic Cancer cranial irradiation small‐cell lung carcinoma thoracic surgery |
| title | Prophylactic cranial irradiation in patients with resected small‐cell lung cancer: A systematic review and meta‐analysis |
| title_full | Prophylactic cranial irradiation in patients with resected small‐cell lung cancer: A systematic review and meta‐analysis |
| title_fullStr | Prophylactic cranial irradiation in patients with resected small‐cell lung cancer: A systematic review and meta‐analysis |
| title_full_unstemmed | Prophylactic cranial irradiation in patients with resected small‐cell lung cancer: A systematic review and meta‐analysis |
| title_short | Prophylactic cranial irradiation in patients with resected small‐cell lung cancer: A systematic review and meta‐analysis |
| title_sort | prophylactic cranial irradiation in patients with resected small cell lung cancer a systematic review and meta analysis |
| topic | cranial irradiation small‐cell lung carcinoma thoracic surgery |
| url | https://doi.org/10.1111/1759-7714.15463 |
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