Meta-analysis Of Prophylactic Cranial Irradiation In The Treatment Of Postoperative Small Cell Lung Cancer

Background: Lung cancer is a high-risk malignant tumor in the world and often ranks first in cancer-related deaths.Among them,small cell lung cancer with a high degree of malignancy accounts for about 13% to 20%,and it is easy to relapse and metastasize in a short time.More than half of the patients with complete remission after radiotherapy and chemotherapy can still have brain metastasis.Prophylactic cranial irradiation(PCI)has been identified as the standard treatment for patients with remission after treatment.However,for some patients who can undergo surgical resection of the lesion,whether PCI is beneficial to this group of people has not yet reached a consensus.Objective: By applying a meta-analysis method to systematically evaluate the effect of PCI on survival benefit in postoperative patients with small cell lung cancer(SCLC),so as to provide evidence-based medicine for clinical practice.Methods: Retrieve databases such as Cochrane Library,Pubmed,Embase,Web of Science,WanFang Database,CNKI databases to collect clinical research on the use of PCI in postoperative small cell lung cancer.Screen literature according to inclusion and exclusion criteria.Quality evaluation of included literature.Use Review Manager software for meta-analysis.Results: A total of 5 retrospective studies were included,1691 patients,315 of whom received PCI.meta analysis results show that PCI can improve the overall survival rate of patients with small cell lung cancer undergoing complete resection as a whole HR=0.58(95%CI:0.45-0.76,P<0.0001),reduce the risk of brain metastasis RR = 0.50(95% CI: 0.32-0.78,P = 0.002).PCI did not bring survival benefit to patients with p stage ?: HR = 0.87(95% CI: 0.34-2.24,P = 0.78).Conclusion: PCI may improve the survival rate of patients with stage II and stage III small cell lung cancer after complete resection and reduce the risk of brain metastasis,while patients with stage p stage ? may not benefit from it.Closely monitor early-stage patients with brain MRI may be an alternative strategy,andneeds more high-quality clinical randomized controlled studies to confirm our conclusion.