Meta-analysis comparing higher and lower dose radiotherapy for palliation in locally advanced lung cancer

Authors

  • Jie-Tao Ma,

    1. Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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  • Jia-He Zheng,

    1. Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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  • Cheng-Bo Han,

    1. Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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  • Qi-Yong Guo

    Corresponding author
    1. Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
    • Correspondence

      Qi-Yong Guo, Department of Radiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street Heping District, Shenyang, Liaoning 110004, China.

      Tel: +86-24 23892620; Fax: +86-24 2392 9902;

      E-mail: qiyongguo123@126.com

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Abstract

The purpose of this meta-analysis was to compare higher dose (≥30 Gy) and lower dose (<30 Gy) radiotherapy (RT) on palliation of symptoms and survival in patients with locally advanced lung cancer. A search of PubMed and Google Scholar was conducted on 10 June 2013 using combinations of the search terms: radiotherapy, non-small-cell lung carcinoma, palliative, supportive, symptom relief. Inclusion criteria were: (i) palliative thoracic RT; (ii) randomized controlled trial; (iii) English language; and (iv) compared outcomes between higher dose (≥30 Gy) and lower dose (<30 Gy) RT. The primary outcome was palliation of symptoms (cough, chest pain, hemoptysis), and 1- and 2-year overall survival. Tests of heterogeneity, sensitivity, and publication bias were performed. Five randomized controlled trials with a total of 1730 patients with lung cancer were included in the meta-analysis. There were 925 patients treated with a higher RT dose (≥30 Gy) and 805 treated with a lower RT dose (<30 Gy). The combined odds ratios (ORs) indicated no significant difference in palliation of cough, chest pain, and hemoptysis between the higher dose and lower dose RT groups (combined ORs = 0.88, 1.83, 1.39, respectively). The 1- and 2-year OS rates were similar between the high and low dose RT groups (combined ORs = 1.09 and 1.38, respectively). This meta-analysis indicates that high dose (≥30 Gy) and lower dose (<30 Gy) RT provide similar symptom palliation and 1- and 2-year OS in patients with locally advanced lung cancer.

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