Dose-response relationship of stereotactic body radiotherapy for ultracentral tumor and comparison of efficacy with central tumor: a meta-analysis
- Authors
- Rim, Chai Hong; Shin, In-Soo; Yoon, Won Sup; Park, Sunmin
- Issue Date
- 8월-2020
- Publisher
- AME PUBL CO
- Keywords
- Lung cancer; central tumor; ultracentral (UC) tumor; stereotactic body radiotherapy (SBRT); stereotactic ablative body radiotherapy
- Citation
- TRANSLATIONAL LUNG CANCER RESEARCH, v.9, no.4, pp.1268 - +
- Indexed
- SCIE
SCOPUS
- Journal Title
- TRANSLATIONAL LUNG CANCER RESEARCH
- Volume
- 9
- Number
- 4
- Start Page
- 1268
- End Page
- +
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/53899
- DOI
- 10.21037/tlcr-20-503
- ISSN
- 2226-4477
- Abstract
- Background: Ultracentral (UC) tumors, a subset of central lung tumors defined as those that abut the proximal bronchial tree (PBT), have been contraindicated for stereotactic body radiotherapy (SBRT). The present meta-analysis evaluated the efficacy of SBRT for UC and central tumors, and dose-response for local control (LC) of UC tumors. Methods: Databases including MEDLINE and EMBASE were searched up to March, 2020, to identify studies regarding SBRT for UC and/or central tumors. The primary endpoints were LC and overall survival (OS), while secondary endpoints were grade >= 3 and 5 complications. Results: Fourteen studies including 892 patients were included. In the UC and central tumor groups, the 1-year OS rates were 82.2% and 85.4% (P=0.556), respectively, and the 2-year OS rates were 66.4% and 71.9% (P=0.522), respectively. The 1and 2-year LC rates in the UC and central tumor groups were 93.9% and 97.8% (P=0.023) and 90.4% and 93.7% (P=0.459), respectively. The pooled grade >= 3 complication rates in the UC and central tumor groups were 9.0% and 4.4% (P=0.06), while the corresponding grade 5 complication rates were 5.7% and 2.1% (P=0.087). The dose-response for LC was shown in the meta regression (P<0.0001), and 1-year LC rates were significantly different (94.4% vs. 59.3%, P<0.001) with very low heterogeneities in both subgroups, with threshold of 85 Gy10. Of the 28 fatalities, 12 (42.8%) were caused by hemorrhage or bronchial stenosis, and another 12 (42.8%) by pneumonia or respiratory failure. Conclusions: The oncologic outcomes of patients with UC and central tumors were comparable postSBRT. A dose of at least >_85 Gy10 is recommended for SBRT of UC tumors. Causes of complications should be further studied as UC tumors are more prone to serious toxicities.
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