The efficacy and safety of Carbon ion radiotherapy for Meningiomas: A Systematic review and meta‐analysis

ObjectiveThe purpose of this systematic review and meta-analysis is to evaluate the efficacy and safety of carbon ion radiotherapy (CI-RT) in improving meningioma by comparing photon and protons radiotherapy.MethodsA comprehensive search for relevant studies published until March 17, 2021, was conducted in PubMed, the Cochrane Library, Chinese Biomedical Literature Database and EMBASE. Statistical analyses were performed with R 4.0.3.ResultsWe identified 396 studies, of which 18 studies involving 985 participants were included. Except for one low quality study, the quality of the included studies was found to be either moderate or high quality. The analyses conducted according random effects model indicated that the 1-year overall survival rate (OS) of benign and non-benign meningiomas after the CI-RT treatment was 99% (95%CL=.91-1.00, I2 = 0%). The overall average 5-year OS for meningiomas was 72% (95%CL=0.52-0.86, I2 = 35%), not as effective as proton radiotherapy (PR-RT) 85% (95%CL=.72-.93, I2 = 73, Q=4.17, df=2, p=.12). Additionally, 5-year OS of atypical meningiomas (81%) was found to be significantly higher than anaplastic meningiomas (52%). The 10-year OS after CI-RT of patients with mixed grade meningioma was 91% (95%CL=.75-.97, I2 = 73%). The 15-year OS after CI-RT 87% (95%CL=.11-1.00) or PR-RT 87% (95%CL=.23-.99, I2 = 79%) were the same (Q=0, df=1, p=.99). After undergoing CI-RT for 3 and 5 years, the LC for benign meningioma was 100% and 88%, respectively, while the 2-year LC of non-benign meningiomas (atypical/anaplastic) was 33%. Headache, sensory impairment, cognitive impairment, and hearing impairment were found to be the most common adverse reactions, with individual incidences of 19.4%, 23.7%, 9.1%, and 9.1%, respectively.ConclusionCI-RT is a rapidly developing technique that has been proven to be an effective treatment against meningioma. The efficacy and safety of CI-RT for meningiomas were similar to those of PR-RT, better than photon radiotherapy (PH-RT). However, there is a need for more prospective trials in the future that can help provide more supportive evidence.

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Efficacy and safety of carbon‐ion radiotherapy for the malignant melanoma: A systematic review

Cancer Medicine ◽

10.1002/cam4.3134 ◽

2020 ◽

Vol 9 (15) ◽

pp. 5293-5305

Author(s):

Chengcheng Li ◽

Qiuning Zhang ◽

Zheng Li ◽

Shuangwu Feng ◽

Hongtao Luo ◽

...

Keyword(s):

Systematic Review ◽

Malignant Melanoma ◽

Carbon Ion Radiotherapy ◽

Efficacy And Safety ◽

Carbon Ion

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Carbon ion radiotherapy for skull base chordomas and chondrosarcomas: a systematic review and meta-analysis of local control, survival, and toxicity outcomes

Journal of Neuro-Oncology ◽

10.1007/s11060-020-03464-1 ◽

2020 ◽

Vol 147 (3) ◽

pp. 503-513 ◽

Cited By ~ 3

Author(s):

Victor M. Lu ◽

Kyle P. O’Connor ◽

Anita Mahajan ◽

Matthew L. Carlson ◽

Jamie J. Van Gompel

Keyword(s):

Systematic Review ◽

Skull Base ◽

Local Control ◽

Meta Analysis ◽

Carbon Ion Radiotherapy ◽

Carbon Ion ◽

Skull Base Chordomas ◽

Control Survival

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Clinical Efficacy and Safety of Proton and Carbon Ion Radiotherapy for Prostate Cancer: A Systematic Review and Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.709530 ◽

2021 ◽

Vol 11 ◽

Author(s):

Meixuan Li ◽

Xiuxia Li ◽

Liang Yao ◽

Xue Han ◽

Wenlong Yan ◽

...

Keyword(s):

Prostate Cancer ◽

Meta Analysis ◽

Proton Beam Therapy ◽

Tumor Stage ◽

Carbon Ion Radiotherapy ◽

Efficacy And Safety ◽

Carbon Ion ◽

Meta Regression ◽

Photon Radiotherapy

BackgroundCarbon ion radiotherapy (CIRT) and proton beam therapy (PBT) are promising methods for prostate cancer, however, the consensus of an increasing number of studies has not been reached. We aimed to provide systematic evidence for evaluating the efficacy and safety of CIRT and PBT for prostate cancer by comparing photon radiotherapy.Materials and MethodsWe searched for studies focusing on CIRT and PBT for prostate cancer in four online databases until July 2021. Two independent reviewers assessed the quality of included studies and used the GRADE approach to rate the quality of evidence. R 4.0.2 software was used to conduct the meta-analysis. A meta-regression test was performed based on the study design and tumor stage of each study.ResultsA total of 33 studies including 13 CIRT- and 20 PBT-related publications, involving 54,101, participants were included. The quality of the included studies was found to be either low or moderate quality. Random model single-arm meta-analysis showed that both the CIRT and PBT have favorable efficacy and safety, with similar 5-year overall survival (OS) (94 vs 92%), the incidence of grade 2 or greater acute genitourinary (AGU) toxicity (5 vs 13%), late genitourinary (LGU) toxicity (4 vs 5%), acute gastrointestinal (AGI) toxicity (1 vs 1%), and late gastrointestinal (LGI) toxicity (2 vs 4%). However, compared with CIRT and PBT, photon radiotherapy was associated with lower 5-year OS (72–73%) and a higher incidence of grade 2 or greater AGU (28–29%), LGU (13–14%), AGI (14–19%), and LGI toxicity (8–10%). The meta-analysis showed the 3-, 4-, and 5-year local control rate (LCR) of CIRT for prostate cancer was 98, 97, and 99%; the 3-, 4-, 5-, and 8-year biochemical relapse-free rate (BRF) was 92, 91, 89, and 79%. GRADE assessment results indicated that the certainty of the evidence was very low. Meta-regression results did not show a significant relationship based on the variables studied (P<0.05).ConclusionsCurrently available evidence demonstrated that the efficacy and safety of CIRT and PBT for prostate cancer were similar, and they may significantly improve the OS, LCR, and reduce the incidence of GU and GI toxicity compared with photon radiotherapy. However, the quantity and quality of the available evidence are insufficient. More high-quality controlled studies are needed in the future.

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