title: Meta-analysis comparing higher and lower dose radiotherapy for palliation in locally advanced lung cancer.
abstract: The purpose of this meta-analysis was to compare higher dose (≥30 Gy) and lower dose (<30 Gy) radiotherapy (RT) on palliation of symptoms and survival in patients with locally advanced lung cancer. A search of PubMed and Google Scholar was conducted on 10 June 2013 using combinations of the search terms: radiotherapy, non-small-cell lung carcinoma, palliative, supportive, symptom relief. Inclusion criteria were: (i) palliative thoracic RT; (ii) randomized controlled trial; (iii) English language; and (iv) compared outcomes between higher dose (≥30 Gy) and lower dose (<30 Gy) RT. The primary outcome was palliation of symptoms (cough, chest pain, hemoptysis), and 1- and 2-year overall survival. Tests of heterogeneity, sensitivity, and publication bias were performed. Five randomized controlled trials with a total of 1730 patients with lung cancer were included in the meta-analysis. There were 925 patients treated with a higher RT dose (≥30 Gy) and 805 treated with a lower RT dose (<30 Gy). The combined odds ratios (ORs) indicated no significant difference in palliation of cough, chest pain, and hemoptysis between the higher dose and lower dose RT groups (combined ORs = 0.88, 1.83, 1.39, respectively). The 1- and 2-year OS rates were similar between the high and low dose RT groups (combined ORs = 1.09 and 1.38, respectively). This meta-analysis indicates that high dose (≥30 Gy) and lower dose (<30 Gy) RT provide similar symptom palliation and 1- and 2-year OS in patients with locally advanced lung cancer.
authors: Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
authors: Jie-Tao
authors: JT
authors: Ma
authors: Jia-He
authors: JH
authors: Zheng
authors: Cheng-Bo
authors: CB
authors: Han
authors: Qi-Yong
authors: QY
authors: Guo
mesh_terms: D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D010166:Palliative Care / Q000379:methods*; D011879:Radiotherapy Dosage; D016896:Treatment Outcome
keywords: Inoperable; locally advanced; lung cancer; palliation; radiotherapy