| Objective: The purpose of this study was to compare the clinical outcomes for sublobar resection(SR)or SR plus intraoperative brachytherapy(SRB)for stage I non-small cell lung cancer(NSCLC).Methods: A systematic search was performed in the Pub Med,EMB ASE,Cochrane Library databases,China national knowledge infrastructure(CNKI)and Wanfang Med Online to identify related studies comparing SR to SRB.Data were collected on local recurrence(LR)as a primary outcome,and regional or distant recurrence(RDR),overall survival(OS),and disease-free survival(DFS)as secondary outcomes.Meta-analysis was carried out using Stata 12.0.Results: A total of 476 patients received SRB,and 617 received SR across 5 studies.Meta-analysis of LR,RDR,OS,and DFS rates showed no significant difference between SRB and SR groups(Relative risk[RR]=0.512 、 0.903 、 1.012,95% Confidence interval [CI]:0.202-1.298,0.690-1.180,0.811-1.262,P=0.159,0.454,0.916).Meta-analysis of OS showed no significant difference(Hazard ratio [HR]=1.070,95%CI:0.695-1.647,P=0.757).However,when biologically effective dose(BED)was more than 100 Gy,the lower LR rate was observed in the SRB group than in the SR group(Relative risk [RR] = 0.143,95% confidence interval [CI]: 0.051-0.397)(P < 0.001).When BED was less than 100 Gy,no significant difference was found in LR rate between two groups(SRB vs.SR:RR = 1.132,95%CI: 0.704-1.821)(P = 0.608).Conclusions: Intraoperative brachytherapy was not associated with reduced risk of regional or distant metastasis or improved outcomes for patients with clinical stage I NSCLC;however,it might reduce the local recurrence rate when BED was more than 100 Gy. |
