Radiation toxicity in patients with collagen vascular disease: A meta-analysis of case-control studies
Abstract
BACKGROUND
Several retrospective series have reported that patients with collagen vascular disease (CVD) are at increased risk of radiation (RT) toxicity. However, the evidence is mixed, and many series lack control groups. We performed a meta-analysis including only case-cohort or randomized studies examining the risk of RT toxicity for patients with CVD compared to controls.
METHODS
MOOSE guidelines were used to perform a comprehensive search identifying case-control or randomized studies reporting RT toxicity outcomes for patients with CVD versus controls. Data were synthesized from studies reporting grade 2 to 3 or more (G2/3+) acute and late RT toxicities. Results were analyzed on the random-effects (RE) model for between-study heterogeneity, otherwise the fixed-effects model (FE) was used. Hazard ratio (HR) or odds ratio (OR) were the effect-size estimators, as appropriate.
RESULTS
Ten studies were included with 4,028 patients (CVD: 406, control: 3622). Patients with CVD had higher rates of acute G2/3+ toxicity (26.2% vs. 16.5%, OR 2.01, p<0.001) and late G2/3+ toxicity (18.4% vs 10.1%, OR 2.37, p<0.001). Higher rates of late G2/3+ toxicity were observed for CVD patients with systemic lupus erythematous (21% vs. 9.7%, OR 2.55, p=0.03), systemic scleroderma (31.8% vs. 9.7%, OR 3.85, p=0.03), rheumatoid arthritis (11.7% vs. 8.4%, OR=2.56; p=0.008), and those irradiated to the pelvis/abdomen (32.2% vs 11.9%, OR 3.29, p=0.001), breast (14.7% vs 4.4%, OR 3.51, p=0.003),…
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: 4,028 participants or records.
Read the paper
Related studies
- Preliminary Toxicity Analysis of 3DCRT versus IMRT on the High Dose Arm of the RTOG 0126 Prostate Cancer Trial
- Adaptive Radiotherapy for Head and Neck Cancer: Initial Clinical Outcomes from a Prospective Trial
- American Association of Physicists in Medicine Task Group 263: Standardizing Nomenclatures in Radiation Oncology
- Motion Management Strategies and Technical Issues Associated with Stereotactic Body Radiotherapy of Thoracic and Upper Abdominal Tumors: A Review from NRG Oncology
- High-dose-rate interstitial brachytherapy as a monotherapy for localized prostate cancer: treatment description and preliminary results of a phase I/II clinical trial
- Highly efficient training, refinement, and validation of a knowledge-based plan quality control system for radiotherapy clinical trials
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.