Open AccessStereotactic ablative radiotherapy versus lobectomy for stage I non‐small cell lung cancer: A systematic review
Author(s) -
Wang Siwei,
Wang Xiaoxiao,
Zhou Qing,
Xu Youtao,
Xia Wenjia,
Xu Weizhang,
Ma ZhiFei,
Qiu Mantang,
You Ran,
Xu Lin,
Yin Rong
Publication year - 2018
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.12574
Subject(s) - medicine , sabr volatility model , lung cancer , stage (stratigraphy) , radiation therapy , odds ratio , ablative case , meta analysis , confidence interval , oncology , randomized controlled trial , surgery , volatility (finance) , paleontology , stochastic volatility , financial economics , economics , biology
Background There is debate regarding the use of stereotactic ablative radiotherapy (SABR) or surgery for patients with early stage non‐small cell lung cancer (NSCLC). This meta‐analysis compared the clinical efficacy of SABR and lobectomy in stage I NSCLC patients. Methods An online search identified eight eligible articles (including 2 trials and 7 cohort studies) for inclusion. The odds ratio (OR) was used as a summary statistic. Overall survival (OS), cause‐specific survival (CSS), and recurrence‐free survival (RFS) were selected to calculate ORs with 95% confidence intervals (CI). Fixed‐effects or random‐effects models were conducted according to study heterogeneity. Results There were no significant differences between SABR and lobectomy in terms of one‐year OS or CSS. Significant benefits of surgery were observed in three‐year OS (OR 2.11, 95% CI 1.55–2.86), three‐year CSS (OR 1.94, 95% CI 1.05–3.57), three‐year RFS (OR 1.63, 95% CI 1.12–2.36), and five‐year OS (OR 2.40, 95% CI 1.71–3.36). In addition, lobectomy demonstrated a beneficial trend in one‐year RFS, five‐year RFS, and CSS. Conclusion Meta‐analyses of current evidence suggested that lobectomy provides better long‐term survival outcomes for stage I NSCLC patients.