Introduction: Stereotactic body radiation therapy (SBRT) is a promising curative treatment for early‐stage NSCLC. It is unclear if survival outcomes for SBRT are influenced by a lack of pathological confirmation of malignancy and staging of disease in these patients. In this systematic review and meta‐analysis, we assess survival outcomes after SBRT in studies with patients with clinically diagnosed versus biopsy‐proven early‐stage NSCLC. Methods: The main databases were searched for trials and cohort studies without restrictions to publication status or language. Two independent researchers performed the screening and selection of eligible studies. Outcomes were overall survival, cancer‐specific survival, and disease‐free survival. The inverse variance method and the random effects method for meta‐analysis were used to assess pooled survival estimates. Results: A total of 11,195 nonduplicate records were identified by the original search strategy. After screening by title and abstract, 1051 potentially eligible records were identified. A total of 43 articles were included. The comparative studies showed lower 3‐year overall survival and lower 2‐year and 5‐year cancer‐specific survival for biopsy‐proven disease compared to clinical disease. However, 5‐year overall survival was the same for both groups. For the pooled estimates, 3‐year disease‐free survival and 2‐year cancer‐specific survival were lower for biopsied disease. Conclusions: Results of this systematic review and meta‐analysis show a discrepancy in oncological outcomes for patients undergoing SBRT for suspected early‐stage NSCLC in whom there is pathologic conformation of malignancy and those who there is only a clinical diagnose of NSCLC. These results emphasize the importance of obtaining pathologic proof of malignancy.

中文翻译：

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SBRT 治疗临床诊断或活检证实的早期非小细胞肺癌的存活率：系统评价和荟萃分析

简介：立体定向放射治疗（SBRT）是一种有前途的早期非小细胞肺癌的治愈性治疗方法。目前尚不清楚 SBRT 的生存结果是否受到缺乏对这些患者的恶性肿瘤和疾病分期的病理学确认的影响。在这项系统评价和荟萃分析中，我们在临床诊断与活检证实的早期 NSCLC 患者的研究中评估了 SBRT 后的生存结果。方法：在不受发表状态或语言限制的情况下，在主要数据库中搜索试验和队列研究。两名独立研究人员对符合条件的研究进行了筛选和选择。结果是总生存期、癌症特异性生存期和无病生存期。荟萃分析的逆方差法和随机效应法用于评估合并生存估计。结果：原始搜索策略共识别出 11,195 条非重复记录。通过标题和摘要筛选后，确定了 1051 条可能符合条件的记录。共收录 43 篇文章。比较研究表明，与临床疾病相比，活检证实的疾病的 3 年总生存率和 2 年和 5 年癌症特异性生存率较低。然而，两组的 5 年总生存率相同。对于汇总估计，活检疾病的 3 年无病生存率和 2 年癌症特异性生存率较低。结论：本系统评价和荟萃分析的结果显示，对于疑似早期 NSCLC 且病理形态为恶性肿瘤的患者和仅临床诊断为 NSCLC 的患者，接受 SBRT 的患者的肿瘤学结果存在差异。这些结果强调了获得恶性肿瘤病理证据的重要性。