Systematic reviewComparison of particle beam therapy and stereotactic body radiotherapy for early stage non-small cell lung cancer: A systematic review and hypothesis-generating meta-analysis
Section snippets
Search strategy and selection criteria
A systematic search was conducted in PubMed, Medline, Google-scholar, and the Cochrane library for studies published between January 2000, and June 2016. The subject heading “non-small cell lung cancer/ carcinoma” was combined with the following terms: “early stage”, “stage I”, “T1”, “T2”, “stereotactic body radiation therapy”, “stereotactic body radiotherapy”, “stereotactic ablative radiotherapy”, “SBRT”, “SABR”, “hypo-fractionated radiotherapy”, “particle beam therapy”, “proton therapy”,
Study selection and characteristics
The study selection process is shown in Suppl. Fig. 1. Among 501 relevant publications on SBRT and 113 relevant publications on PBT, 205 full text articles for SBRT and 19 full text articles for hypo-fractionated PBT (proton and carbon ion therapy) were assessed for eligibility. Of these, 72 studies on photon SBRT and 9 studies on PBT for ES NSCLC were selected [10], [12], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40]
Discussion
Through a systematic review of the literature, data extracted from 72 studies on SBRT and 9 studies on hypo-fractionated PBT for ES NSCLC from North America, Europe and Asia were analyzed in a meta-analysis, which represents the most comprehensive review of the subject matter to date. Even with relatively more advanced tumors in size and T stage, patients treated with PBT were found to have significantly better OS and PFS than those treated with photon SBRT in the weighted multivariate analysis
Conclusion
Although hypo-fractionated PBT may lead to additional clinical benefit when compared with photon SBRT, no statistically significant survival benefit from PBT over SBRT was observed in the treatment of ES NSCLC in this hypothesis-generating meta-analysis after adjusting for potential confounding variables.
Conflict of interest
None
Funding source
None
Acknowledgement
We would like to thank Ms. Jin H. Jiao for her significant contribution to the conduct of the systematic literature search.
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