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Prophylactic irradiation of tracts in patients with malignant pleural mesothelioma: A systematic review and meta-analysis of randomized trials.
Lee, Chia Ching; Soon, Yu Yang; Vellayappan, Balamurugan; Leong, Cheng Nang; Koh, Wee Yao; Tey, Jeremy C S.
Afiliação
  • Lee CC; Department of Radiation Oncology, National University Cancer Institute, Singapore; National University Hospital, Singapore; National University Health System, Singapore; National University of Singapore, Singapore. Electronic address: chiaching.lee@mohh.com.sg.
  • Soon YY; Department of Radiation Oncology, National University Cancer Institute, Singapore; National University Hospital, Singapore; National University Health System, Singapore; National University of Singapore, Singapore. Electronic address: yu_yang_soon@nuhs.edu.sg.
  • Vellayappan B; Department of Radiation Oncology, National University Cancer Institute, Singapore; National University Hospital, Singapore; National University Health System, Singapore; National University of Singapore, Singapore. Electronic address: bala_vellayappan@nuhs.edu.sg.
  • Leong CN; Department of Radiation Oncology, National University Cancer Institute, Singapore; National University Hospital, Singapore; National University Health System, Singapore; National University of Singapore, Singapore. Electronic address: cheng_nang_leong@nuhs.edu.sg.
  • Koh WY; Department of Radiation Oncology, National University Cancer Institute, Singapore; National University Hospital, Singapore; National University Health System, Singapore; National University of Singapore, Singapore. Electronic address: wee_yao_koh@nuhs.edu.sg.
  • Tey JCS; Department of Radiation Oncology, National University Cancer Institute, Singapore; National University Hospital, Singapore; National University Health System, Singapore; National University of Singapore, Singapore. Electronic address: jeremy_tey@nuhs.edu.sg.
Crit Rev Oncol Hematol ; 160: 103278, 2021 Apr.
Article em En | MEDLINE | ID: mdl-33675903
ABSTRACT

INTRODUCTION:

The role of prophylactic irradiation of tracts (PIT) to prevent tumor seeding at the site of a diagnostic or therapeutic intervention in patients with malignant pleural mesothelioma (MPM) is controversial. This study aimed to determine the efficacy of PITs in preventing procedure tract metastases (PTM) after a chest wall procedure in MPM. MATERIALS AND

METHODS:

We searched various databases from inception date to April 2020 for randomized controlled trials (RCTs) comparing PIT with no PIT in patients who had a chest wall procedure for MPM. We assessed the risk of bias of individual RCT using the RoB2 tool. The primary outcome was the occurrence of PTM. Meta-analysis was performed using random-effects model. We employed the GRADE approach to assess the certainty of the evidence.

RESULTS:

We identified five RCTs including 737 patients. Two RCTs had a low risk of bias. PIT was associated with a significant reduction in the odds of PTM (odd ratio, 0.55; 95 % confidence interval, 0.32 to 0.95; P-value = 0.03; I2 = 13 %; GRADE moderate certainty). One RCT reported no difference in overall survival outcome with the use of PIT. None of the RCTs performed subgroup analyses. Sensitivity analyses showed similar results when limited to RCTs with low risk of bias.

CONCLUSION:

PIT significantly reduces the occurrence of PTM in patients with MPM who had a diagnostic or therapeutic chest wall procedure.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pleurais / Mesotelioma Maligno / Mesotelioma Tipo de estudo: Clinical_trials / Systematic_reviews Limite: Humans Idioma: En Revista: Crit Rev Oncol Hematol Assunto da revista: HEMATOLOGIA / NEOPLASIAS Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pleurais / Mesotelioma Maligno / Mesotelioma Tipo de estudo: Clinical_trials / Systematic_reviews Limite: Humans Idioma: En Revista: Crit Rev Oncol Hematol Assunto da revista: HEMATOLOGIA / NEOPLASIAS Ano de publicação: 2021 Tipo de documento: Article