HRCT for Non-Small Cell Lung Cancer: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

MI Denghai ^1,2,3 , LI Zheng ^1,2 , YANG Kehu ^1,2 , TIAN Jinhui ¹ , WANG Daoying ^1,2

1. Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China;2. The First Clinical Medicine College of Lanzhou University, Lanzhou 730000, China;3. Gansu Provincial Second People’s Hospital, Lanzhou 730000, China;

Corresponding author：

TIAN Jinhui, Email:

Keywords：

Non-small cell lung cancer; Hyperthermia; Radiotherapy; Chemotherapy; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20110215

Video：

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Objective　 To evaluate the clinical efficacy and safety of hyperthermia combined with radiotherapy and chemotherapy (HRCT) for non-small cell lung cancer (NSCLC), so as to provide references for further clinical practice and research.
Methods　 The databases such as The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched on computer from the date of their establishment to May 1st of 2011, and other sources as supplied were also retrieved to collect all the relevant randomized controlled trials (RCTs) on comparing HRCT with non-HRCT. The quality of the included trials was assessed according to the Cochrane Handbook 5.1 for Systematic Review and the features of this study as well. Meta-analyses were conducted by using RevMan 5.1 software.
Results　 A total of eight RCTs involving 546 patients were included. The results of meta-analyses showed that: a) Total effective rate: The total effective rate of HRCT was higher than other non-HRCT therapies, and there were significant differences in HRCT compared with radio-chemotherapy, hyperthermia plus chemotherapy, and pure chemotherapy, the OR and 95%CI were 2.05 (1.18, 3.56), 3.41 (1.12, 10.38), and 6.11 (1.20, 31.16), respectively; and b) Safety evaluation: The incidence rates of radiation pneumonitis, radiation esophagitis and granulocytopenia were all lower in the HRCT group than that in the radio-chemotherapy group, but the significant differences were only found in the incidence rate of granulocytopenia (OR=0.34 (0.19, 0.59).
Conclusion　 Compared with other therapies, HRCT tends to improve the clinical efficacy and safety for NSCLC, but this result needs to be proved by more clinical trials. HRCT is superior to the routine radio-chemotherapy in both efficacy and safety, but the relevant evidence for proving its long-term efficacy and safety is still required.

Citation： MI Denghai,LI Zheng,YANG Kehu,TIAN Jinhui,WANG Daoying. HRCT for Non-Small Cell Lung Cancer: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2011, 11(11): 1262-1267. doi: 10.7507/1672-2531.20110215 Copy

1.	3 Furuse K, Fukuoka M, Kawahara M, et al . Phase III study of concurrent versus sequential thoracic radiotherapy in combination with mitomycin, vindesine, and cisplatin in unresectable stage III non-small-cell lung cancer. J Clin Oncol , 1999, 17 (9): 2692-2699.
2.	12 Zolzer F, Streffer C. G2-phase delays after irradiation and/or heat treatment as assessed by two-parameter flow cytometry. Radiat Res , 2001, 155 (1 Pt 1): 50-56.
3.	13 Horsman MR, Overgaard J. Hyperthermia: a potent enhancer of radiotherapy. Clin Oncol (R Coll Radiol) , 2007, 19 (6): 418-426.
4.	14 Brozovic A, Simaga S, Osmak M. Induction of heat shock protein 70 in drug-resistant cells by anticancer drugs and hyperthermia. Neoplasma , 2001, 48 (2): 99-103.
5.	15 Nikfarjam M, Muralidharan V, Malcontenti-Wilson C, et al . The apoptotic response of liver and colorectal liver metastases to focal hyperthermic injury. Anticancer Res , 2005, 25 (2B): 1413-1419.
6.	16 Sawaji Y, Sato T, Takeuchi A, et al . Anti-angiogenic action of hyperthermia by suppressing gene expression and production of tumour-derived vascular endothelial growth factor in vivo and in vitro. Br J Cancer , 2002, 86 (10): 1597-1603.
7.	陆再英, 终南山. 内科学. 第七版. 北京: 人民卫生出版社, 2009: 123-134.
8.	白春学, 张新. 肺癌的治疗现状. 中华结核和呼吸杂志, 2006, 29 (3): 146.
9.	赵军, 张静, 张丽华, 等. 热疗联合同步放化疗治疗局部晚期非小细胞肺癌的疗效及对免疫功能的影响. 肿瘤基础与临床, 2010, 23 (4): 317-319.
10.	彭永海, 欧阳学农, 解方为. 同步放化疗联合射频热疗治疗局部晚期非小细胞肺癌临床分析. 第四军医大学学报, 2009, 30 (11): 1023-1025.
11.	孙蔚亮, 李小瑞, 张清琴, 等. 热疗联合放疗治疗局部晚期非小细胞肺癌疗效观察. 现代肿瘤医学, 2008, 16(7): 1153-1154.
12.	曹科, 曹培国. 热疗联合化放疗治疗晚期非小细胞肺癌42例临床观察. 中国医学工程, 2007, 15 (8): 678-680, 683.
13.	陈金忠. 诱导化疗加放疗联合射频透热治疗非小细胞肺癌47例效果观察. 南通大学学报(医学版), 2006, 26 (2): 135, 137.
14.	戴辉, 侯友贤, 闫业勇, 等. 放疗热疗化疗三联综合治疗晚期非小细胞肺癌64例. 实用医学杂志, 2001, 17 (11): 1071-1072.
15.	周桂霞, 崔书祥, 常庆森, 等. 放热化综合治疗非小细胞肺癌的远期疗效. 军医进修学院学报, 2001, 22 (3): 199-201.
16.	周桂霞, 崔书祥, 常庆森, 等. 放疗热疗化疗综合治疗非小细胞肺癌. 中华理疗杂志, 1999, 22 (1): 7-9.

1. 3 Furuse K, Fukuoka M, Kawahara M, et al . Phase III study of concurrent versus sequential thoracic radiotherapy in combination with mitomycin, vindesine, and cisplatin in unresectable stage III non-small-cell lung cancer. J Clin Oncol , 1999, 17 (9): 2692-2699.
2. 12 Zolzer F, Streffer C. G2-phase delays after irradiation and/or heat treatment as assessed by two-parameter flow cytometry. Radiat Res , 2001, 155 (1 Pt 1): 50-56.
3. 13 Horsman MR, Overgaard J. Hyperthermia: a potent enhancer of radiotherapy. Clin Oncol (R Coll Radiol) , 2007, 19 (6): 418-426.
4. 14 Brozovic A, Simaga S, Osmak M. Induction of heat shock protein 70 in drug-resistant cells by anticancer drugs and hyperthermia. Neoplasma , 2001, 48 (2): 99-103.
5. 15 Nikfarjam M, Muralidharan V, Malcontenti-Wilson C, et al . The apoptotic response of liver and colorectal liver metastases to focal hyperthermic injury. Anticancer Res , 2005, 25 (2B): 1413-1419.
6. 16 Sawaji Y, Sato T, Takeuchi A, et al . Anti-angiogenic action of hyperthermia by suppressing gene expression and production of tumour-derived vascular endothelial growth factor in vivo and in vitro. Br J Cancer , 2002, 86 (10): 1597-1603.
7. 陆再英, 终南山. 内科学. 第七版. 北京: 人民卫生出版社, 2009: 123-134.
8. 白春学, 张新. 肺癌的治疗现状. 中华结核和呼吸杂志, 2006, 29 (3): 146.
9. 赵军, 张静, 张丽华, 等. 热疗联合同步放化疗治疗局部晚期非小细胞肺癌的疗效及对免疫功能的影响. 肿瘤基础与临床, 2010, 23 (4): 317-319.
10. 彭永海, 欧阳学农, 解方为. 同步放化疗联合射频热疗治疗局部晚期非小细胞肺癌临床分析. 第四军医大学学报, 2009, 30 (11): 1023-1025.
11. 孙蔚亮, 李小瑞, 张清琴, 等. 热疗联合放疗治疗局部晚期非小细胞肺癌疗效观察. 现代肿瘤医学, 2008, 16(7): 1153-1154.
12. 曹科, 曹培国. 热疗联合化放疗治疗晚期非小细胞肺癌42例临床观察. 中国医学工程, 2007, 15 (8): 678-680, 683.
13. 陈金忠. 诱导化疗加放疗联合射频透热治疗非小细胞肺癌47例效果观察. 南通大学学报(医学版), 2006, 26 (2): 135, 137.
14. 戴辉, 侯友贤, 闫业勇, 等. 放疗热疗化疗三联综合治疗晚期非小细胞肺癌64例. 实用医学杂志, 2001, 17 (11): 1071-1072.
15. 周桂霞, 崔书祥, 常庆森, 等. 放热化综合治疗非小细胞肺癌的远期疗效. 军医进修学院学报, 2001, 22 (3): 199-201.
16. 周桂霞, 崔书祥, 常庆森, 等. 放疗热疗化疗综合治疗非小细胞肺癌. 中华理疗杂志, 1999, 22 (1): 7-9.

Chinese Journal of Evidence-Based Medicine

HRCT for Non-Small Cell Lung Cancer: A Meta-Analysis

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