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Radiother Oncol. 2010 Apr;95(1):32-40. doi: 10.1016/j.radonc.2009.08.003. Epub 2009 Sep 3.

Comparison of the effectiveness of radiotherapy with photons, protons and carbon-ions for non-small cell lung cancer: a meta-analysis.

Author information

1
Department of Radiation Oncology (MAASTRO Clinic), Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands. janneke.grutters@maastro.nl

Abstract

PURPOSE:

To provide a comparison between radiotherapy with photons, protons and carbon-ions in the treatment of Non-Small-Cell Lung Cancer (NSCLC), performing a meta-analysis of observational studies.

METHODS:

Eligible studies on conventional radiotherapy (CRT), stereotactic radiotherapy (SBRT), concurrent chemoradiation (CCR), proton therapy and carbon-ion therapy were searched through a systematic review. To obtain pooled estimates of 2- and 5-year disease-specific and overall survival and the occurrence of severe adverse events for each treatment modality, a random effects meta-analysis was carried out. Pooled estimates were corrected for effect modifiers.

RESULTS:

Corrected pooled estimates for 2-year overall survival in stage I inoperable NSCLC ranged from 53% for CRT to 74% for carbon-ion therapy. Five-year overall survival for CRT (20%) was statistically significantly lower than that for SBRT (42%), proton therapy (40%) and carbon-ion therapy (42%). However, caution is warranted due to the limited number of patients and limited length of follow-up of the particle studies.

CONCLUSION:

Survival rates for particle therapy were higher than those for CRT, but similar to SBRT in stage I inoperable NSCLC. Particle therapy may be more beneficial in stage III NSCLC, especially in reducing adverse events.

PMID:
19733410
DOI:
10.1016/j.radonc.2009.08.003
[Indexed for MEDLINE]

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