A Systemic Study Of Accelerated Hyperfractionated Radiotherapy Combined With Chemotherapy For Limited Stage Small-cell Lung Cancer

Objective: To evaluate the efficacy and safety of accelerated hyperfractionated radiotherapy combined with chemotherapy for limited stage small-cell lung cancer Meta-analysist.Retrospectively analysis the clinical date of accelerated hyperfractionated radiotherapy combined with chemotherapy for limited stage small-cell lung cancer.Methods: Two researchers searched relevant literatures in-CNKI,Wan Fang,CBM,VIP Database,PubMed,Cochrane Library,EMBASE,Web of Science,and biomedical literature database.The randomized controlled trials of accelerated hyperfractionated radiotherapy versus convention radiotherapy for limited stage small-cell lung cancer were included.Two reviewers independently screened studies according to the inclusion and exclusion criteria,extracted data and assessed quality of the included studies.Then Metaanalysis was conducted using RevMan 5.3software.Using retrospectively analysis the efficiency and safty of accelerated hyperfractionated radiotherapy combined with chemotherapy for limited stage small-cell lung cancer.Results: Eight control trials involving 1326 patients were included.The Meta analysis showed that there was statistical significance between accelerated hyperfractionated radiotherapy and convention radiotherapy combined with chemotherapy group in 2-year survival rates [odds ratio(OR)= 1.25,95% confidence interval(CI):1.01~1.56,P=0.04].While there were no statistical difference in response rate(OR=1.65,95%CI:0.85~3.22,P=0.14),5-year survival rates(OR=1.43,95% CI:0.83~2.48,P=0.2).In terms of adverse reactions,there were statistical significances between HFRT and CR group in grade 3 or more serious radiation esophagitis(OR=2.10,95%CI:1.53~2.88,P<0.00001),in grade 3 or more serious radiation pneumonitis(OR=1.83,95%CI:1.09~3.06,P=0.02)but there was no statistical difference between two groups for grade 3 or greater blood toxicity reaction.For further subset analysis in induction chemotherapy sequence,3 cycles of induction chemotherapy followed by concurrent radiotherapy compared in 1cycle or 2cycles of induction chemotherapy followed by concurrent radiotherapy,there were no statistical significances in 2-year survival rates(OR=0.92,95% CI 0.64~1.31,P=0.64;OR=1.10,95% CI 0.66~1.83,P=0.72).For further subset analysis in radiotherapysequential and synchronous,there were no statistical significances in 2-year survival rates(OR=0.93,95% CI:0.73~1.19,P=0.57),5-year survival rates(OR=0.94,95% CI:0.54~1.62,P=0.82).The retrospectively analysis showed that there was no statistical significance between accelerated hyperfractionated radiotherapy and convention radiotherapy combined with chemotherapy group in 1-year survival rates.There were no statistical difference in response rate and adverse reactions.Conclusion: Compared with convention radiotherapy accelerated hyperfractionated radiotherapy combined with chemotherapy for the LD-SCLC-patients can improve the 2-year survival rate,but the treatment may increase the incidence of grade 3 or more severe radiation esophagitis and radiation pneumonitis.The retrospectively analysis showed that there was no significance diffierence between accelerated hyperfractionated radiotherapy and convention radiotherapy combined with chemotherapy group in 1-year survival rates,response rate and adverse reactions.