Can high-risk CT features suggest local recurrence after stereotactic body radiation therapy for lung cancer? A systematic review and meta-analysis Review

   

Authors:	Kim, T. H.; Woo, S.; Halpenny, D. F.; Kim, Y. J.; Yoon, S. H.; Suh, C. H.
Review Title:	Can high-risk CT features suggest local recurrence after stereotactic body radiation therapy for lung cancer? A systematic review and meta-analysis
Abstract:	Purpose: To perform a systematic review and meta-analysis evaluating usefulness of high-risk CT features (HRFs) on follow-up CT in detecting local recurrence after stereotactic body radiation therapy (SBRT) in lung cancer patients. Methods: Pubmed and EMBASE were searched up to January 11th, 2019. We included studies that differentiated local recurrence from post-SBRT changes after SBRT on follow-up CT in lung cancer patients. Methodological quality was assessed using QUADAS-2. The association between HRFs and local recurrence were pooled in the form of odds ratio (OR) using the random effects model. Heterogeneity was examined by the Inconsistency index (I2). Results: Eight studies were included, consisting of 356 lung cancer patients. The overall prevalence of patients with local recurrence was 18.8 % (67/356). Compared with post-SBRT changes, local recurrence after SBRT more frequently demonstrated air-bronchogram disappearance (OR = 7.15), bulging margin (OR = 24.12), craniocaudal growth (OR = 26.07), enlargement after 12 months (OR = 28.11), enlarging opacity (OR = 7.92), linear margin disappearance (OR = 29.24), and sequential enlargement (OR = 83.23) (p ≤ 0.02). Pleural effusion appearance was not related with local recurrence (p = 0.82). Heterogeneity varied among HRFs (I2 = 0–91 %). The quality of the studies was considered moderate. Conclusions: Several HRFs on follow-up CT after SBRT were useful in suggesting local recurrence. These HRFs may help raise clinical suspicion of local recurrence, initiate prompt additional test for confirmation and perform subsequent proper personalized salvage treatment. © 2020 Elsevier B.V.
Keywords:	clinical feature; cancer recurrence; salvage therapy; cancer growth; cancer patient; follow up; quality control; disease association; prevalence; lung cancer; high risk patient; statistical analysis; systematic review; pleura effusion; stereotactic body radiation therapy; statistical model; meta analysis; computed tomography; random effects model; personalized medicine; meta-analysis; x-ray; radiological parameters; stereotactic radiation therapy; human; priority journal; article; x-ray computed tomography; air bronchogram; inconsistency index
Journal Title:	European Journal of Radiology
Volume:	127
ISSN:	0720-048X
Publisher:	Elsevier B.V
Date Published:	2020-06-01
Start Page:	108978
Language:	English
DOI:	10.1016/j.ejrad.2020.108978
PROVIDER:	scopus
PUBMED:	32298960
PMCID:	PMC7424838
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85083046307&doi=10.1016%2fj.ejrad.2020.108978&partnerID=40&md5=716a7eb366dfd9294160e2b5b2d283c8
Notes:	Article -- Source: Scopus

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