Stereotactic Body Radiotherapy vs Conventional Radiotherapy in Pain Relief for Bone Metastases: A Systematic Review and Meta-Analysis
Abstract
PURPOSE
This study aimed to investigate the difference in pain relief between stereotactic body radiotherapy (SBRT) and conventional radiotherapy (cRT) for patients with bone metastases.
METHODS AND MATERIALS
Clinical trials and observational studies comparing SBRT vs cRT for bone metastases were retrieved. The main endpoint is pain relief after radiotherapy; the secondary endpoints are pain score change, local progression-free survival (PFS), re-irradiation rate, and toxic events. When there is a significant heterogeneity, the random-effects model is applied. Otherwise, the fixed-effects model is used. Analyses of all included studies were performed first, followed by analyses of randomized controlled trials (RCTs) only.
RESULTS
Six RCTs, one prospective cohort study, and three retrospective observational studies were enrolled. 448 patients received SBRT, and 445 patients received cRT between 2004 and 2019. All prospective studies defined the lesions as oligometastatic. Pooled results based on all included studies indicated that SBRT was generally associated with a higher overall relief rate (P < 0.001 at three months; P = 0.015 at six months) and complete relief rate (P = 0.029 at one month; P < 0.001 at six months). Pooled results based on RCTs indicated that at three and six months, SBRT was associated with a higher overall relief rate (P < 0.001 and P = 0.017, respectively) and complete relief rate (P < 0.001 and P < 0.00, respectively). Subgroup analyses indicated that…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 448 participants or records.
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