Effectiveness and Safety of Lattice Radiotherapy in Treating Large Volume Tumors: A Systematic Review and Meta-analysis Based on Single-arm Clinical Studies.
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Abstract
Background: Lattice radiotherapy (LRT) is a novel spatially fractionated radiotherapy technique specifically designed to treat large tumors more effectively. By alternating high-dose and low-dose regions within the tumor, LRT generates a highly diverse dose distribution.
Aims: To review recent literature on LRT to determine its therapeutic efficacy, survival outcomes, and adverse event rates in treating large-volume tumors, thereby strengthening the evidence base for clinical application.
Study design: Systematic review and meta-analysis.
Methods: We conducted a meta-analysis of all relevant LRT studies identified in four databases-PubMed, Embase, the Cochrane Library, and Web of Science-from their inception to September 2024. Only full-text articles were considered eligible. This study adhered to the 2020 PRISMA guidelines.
Results: The meta-analysis included seven single-arm studies comprising 187 patients. The pooled 3-month complete response rate and partial response rate were 36.67% and 42.49%, respectively, while the three-month progressive disease rate was 7.10%. The tumor volume was reduced by 48.95%. According to survival analysis, the pooled 6-month overall survival rate was 79.27%, with a median response time of 4.25 months. The pooled rates of mild and moderate-to-severe adverse events were 19.40% and 3.37%, respectively. LRT has demonstrated high local control rates and a favorable safety profile in managing large-volume tumors.
Conclusion: This is the first systematic meta-analysis examining the efficacy and safety of LRT in treating large-volume tumors. Although further high-quality studies are needed for validation, LRT exhibits encouraging efficiency and safety in patients with large solid tumors exceeding 5 cm in diameter.
背景：点阵放射治疗（LRT）是一种新型的空间分割放射治疗技术，专门用于更有效地治疗大肿瘤。通过肿瘤内高剂量和低剂量区域的交替，LRT产生了高度多样化的剂量分布。目的：回顾近年来LRT治疗大体积肿瘤的疗效、生存结局及不良事件发生率，为临床应用强化证据基础。研究设计：系统评价和荟萃分析。方法：我们对四个数据库（pubmed、Embase、Cochrane图书馆和Web of science）从建立到2024年9月的所有相关LRT研究进行了荟萃分析。只有全文文章才被认为符合条件。本研究遵循2020年PRISMA指南。结果：meta分析包括7项单臂研究，共187例患者。合计3个月完全缓解率和部分缓解率分别为36.67%和42.49%，3个月疾病进展率为7.10%。肿瘤体积缩小48.95%。根据生存分析，合并6个月总生存率为79.27%，中位缓解时间为4.25个月。轻、中至重度不良事件合计发生率分别为19.40%和3.37%。LRT在治疗大体积肿瘤中具有较高的局部控制率和良好的安全性。结论：这是第一个系统的荟萃分析，研究了LRT治疗大体积肿瘤的有效性和安全性。虽然需要进一步的高质量研究来验证，但LRT在直径超过5cm的大型实体瘤患者中显示出令人鼓舞的效率和安全性。
期刊介绍：
The Balkan Medical Journal (Balkan Med J) is a peer-reviewed open-access international journal that publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports and clinical images, invited reviews, editorials, letters, comments and letters to the Editor including reports on publication and research ethics. The journal is the official scientific publication of the Trakya University Faculty of Medicine, Edirne, Turkey and is printed six times a year, in January, March, May, July, September and November. The language of the journal is English.
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