立体定向体部放疗治疗寡转移性非小细胞肺癌的肿瘤学疗效与安全性：一项系统性荟萃分析。
完整摘要 · 中文译文
目的：随着临床对寡转移（OM）局部巩固治疗兴趣的增加，立体定向体部放疗（SBRT）已成为一种根治性和最佳的治疗方式。本研究将寡进展（OPD）、寡复发（ORD）和寡持续（OPSD）状态进行分层——并结合单病灶亚组分析——以系统评估SBRT治疗寡转移性NSCLC的疗效和安全性。 材料与方法：本荟萃分析利用Pubmed、Embase和Medline进行。定量合成纳入18项符合条件的研究，共包含1,105例患者。评估的临床终点为总生存期（OS）、无进展生存期（PFS）、局部控制（LC）以及严重（3级或以上）治疗相关毒性的发生率。 结果：合并估计显示出稳健的肿瘤学结局；2年OS为60.0%（95% CI，50.4-68.8%），1年PFS为65.8%（95% CI，52.7-76.8%），2年LC率为74.2%（95% CI，63.9-82.4%）。严重毒性（≥3级）的发生率为4.5%，主要表现为放射性肺炎和食管炎。亚组分析显示，单转移病灶比例较高（>59%）者表现出倾向于更优2年OS的边缘性阳性趋势（67.5% vs. 47.8%，p = 0.069）。 结论：本荟萃分析表明，SBRT对寡转移性NSCLC患者产生良好的治疗结局，且毒性可控。当解剖学上可行时，推荐给予消融剂量——生物有效剂量为100 Gy10。Fur 此外，按寡转移亚型制定立体定向体部放疗（SBRT）策略——对同时性疾病/寡进展性疾病（ORD）采用 upfront 根治性 SBRT，对寡持续性/寡进展性疾病（OPSD/OPD）采用挽救性 SBRT——对于最大化治疗效果至关重要。
完整摘要 · 英文原文
PURPOSE: With the increasing clinical interest on local consolidative therapies for oligometastasis (OM), stereotactic body radiotherapy (SBRT) has emerged as a definitive and optimal treatment modality. This study stratifies oligoprogressive (OPD), oligorecurrent (ORD), and oligopersistent (OPSD) states-alongside single-lesion subgroup analyses-to systematically evaluate the efficacy and safety of SBRT for oligometastatic NSCLC. MATERIALS AND METHODS: This meta-analysis was conducted utilizing the Pubmed, Embase and Medline. The quantitative synthesis included 18 eligible studies comprising a total of 1,105 patients. The clinical endpoints assessed were overall survival (OS), progression-free survival (PFS), local control (LC), and the incidence of severe (grade 3 or higher) treatment-related toxicities. RESULTS: The pooled estimates demonstrated robust oncological outcomes; 2-year OS of 60.0% (95% CI, 50.4-68.8%), 1-year PFS of 65.8% (95% CI, 52.7-76.8%), and 2-year LC rate of 74.2% (95% CI, 63.9-82.4%). The incidence of severe toxicities (grade ≥ 3) was 4.5%, predominantly manifesting as radiation pneumonitis and esophagitis. Subgroup analyses revealed that a higher prevalence of single-metastatic lesions (> 59%) exhibited a borderline positive trend toward superior 2-year OS (67.5% vs. 47.8%, p = 0.069). CONCLUSION: This meta-analysis indicates that SBRT yields favorable treatment outcomes for patients with oligometastatic NSCLC with manageable toxicities. When anatomically feasible, delivering an ablative dose-100 Gy10 in biologically effective dose-is recommended. Furthermore, tailoring SBRT strategies by oligometastatic subtype-upfront radical SBRT for synchronous disease/ORD and salvage SBRT for OPSD/OPD-is essential to maximize the treatment efficacy.