论文部分内容阅读
Objective To clear the optimal time of concurrent thoracic radiotherapy (TRT) with etoposide and cisplatin/carboplatin (EP/EC) chemotherapy for limited-disease small cell lung cancer (LD SCLC).Methods Randomized controlled trials were identified according to MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, and so on comparing early to late concurrent TRT with EP/EC chemotherapy for LD SCLC.Early thoracic radiotherapy (ERT) was defined as beginning radiation within 30 days after the start of chemotherapy.Results There are three eligible randomized controlled trials.No significance difference in objective response was detected between early concurrent TRT and late concurrent TRT (RR: 1.01, 95% CI 0.86-1.18, P=0.90).Similar result was detected in 1-, 2-, 3-, and 5-year survival rates between early concurrent TRT and late concurrent TRT (RR: 1.06, 95% CI 0.88-1.27, P=0.56; RR: 1.15, 95% CI 0.77-1.71, P=0.49; RR: 0.90, 95% CI 0.66-1.22, P=0.49; RR: 1.18, 95% CI 0.64-2.16, P=0.60).Total grade 3-4 adverse events including anemia, leucopenia, neutropenia, thrombocytopenia, nausea and vomiting, infection, esophageal toxicity, pulmonary toxicity, alopecia and hemorrhage in early concurrent TRT were significantly higher than that in late concurrent TRT (RR: 1.21, 95% CI 1.03-1.43, P=0.02).Conclusion The result of our work indicates that survival rate of LD-SCLC with late concurrent TRT combined EP/EC chemotherapy is similar with early concurrent TRT, while grade 3-4 adverse events were less.