Evidence map›Paper›PMID 33708926›Full record

ArticleAnnals of translational medicine2021

Role of thoracic radiotherapy in extensive stage small cell lung cancer: a systemic review and meta-analysis.

Ao-Mei Li, Han Zhou, Yang-Yang Xu, Xiao-Qin Ji, Tian-Cong Wu, Xi Yuan, Chang-Chen Jiang, Xi-Xu Zhu, Ping Zhan, Ze-Tian Shen

Abstract read
In one paragraph

Article in Annals of translational medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ao-Mei LiDepartment of Radiation Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Han ZhouDepartment of Radiation Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Yang-Yang XuDepartment of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, China.
Xiao-Qin JiDepartment of Radiation Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Tian-Cong WuDepartment of Radiation Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Xi YuanDepartment of Radiation Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Chang-Chen JiangDepartment of Radiation Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Xi-Xu ZhuDepartment of Radiation Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Ping ZhanDepartment of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing Medical University, Nanjing, China.
Ze-Tian ShenDepartment of Radiation Oncology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe role of thoracic consolidation radiotherapy in patients with extensive stage small cell lung cancer (ES-SCLC) remains controversial. This study aimed to evaluate the efficacy of thoracic radiotherapy (TRT) in these patients.

methodsA systematic literature search was performed in PubMed, Embase, and the Cochrane library to identify qualified clinical studies. The hazard ratios (HRs) and 95% confidence intervals (CIs) of overall survival (OS), progression-free survival (PFS) and local recurrence-free survival (LRFS) were extracted, and toxicity of the TRT group versus non-TRT group was analyzed.

resultsA total of 12 studies were included in this meta-analysis, including 936 patients in the TRT group and 1,059 patients in the non-TRT group. The combined results showed that TRT significantly improved OS (HR =0.65; 95% CI: 0.55-0.77, P<0.00001), PFS (HR =0.64; 95% CI: 0.56-0.72, P<0.00001) and LRFS (HR =0.38, 95% CI: 0.26-0.53, P<0.00001). Subgroup analysis showed that OS benefits were observed in patients receiving sequential TRT (HR =0.67; 95% CI: 0.54-0.84, P=0.0006). The addition of TRT significantly improved OS in patients over 65 years of age (HR =0.55; 95% CI: 0.40-0.74, P=0.0001). For patients with only one organ metastasis, there was no significant difference in OS between the two groups (HR =0.61; 95% CI: 0.36-1.01, P=0.06). There was no statistical difference in hematologic toxicity (leukopenia, thrombocytopenia, anemia) and non-hematologic toxicity (nausea or vomiting) between the two groups. The incidence of grade ≥3 esophageal toxicity was 4.6% in the TRT group and 0% in the non-TRT group (P=0.0001). Grade ≥3 bronchopulmonary toxicity was 2.9% in the TRT group and 0.8% in the non-TRT group (P=0.02).

conclusionsTRT improves OS, PFS and LRFS in patients with ES-SCLC, with a low increase in esophageal and bronchopulmonary toxicity. More randomized controlled trials (RCTs) are expected to confirm our conclusions. PROSPERO REGISTRATION NUMBER: CRD42020190575.

Indexed as

meta-analysisSmall cell lung cancer (SCLC)thoracic radiotherapy (TRT)

Identifiers

PMID33708926
PMCPMC7944300

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.