Safety and efficacy of bridging radiation therapy prior to CD19 CAR T for non-Hodgkin lymphoma: a systematic review and meta-analysis.

However, its impact on outcomes of CART19 therapy is not established.

然而，其对CART19治疗结果的影响尚未确定。

We conducted a systematic reviewand meta-analysisto estimate the safety and efficacy of BRT prior to CART19 therapy.

我们进行了一项系统评价和荟萃分析，以估计在CART19治疗之前进行B细胞去除治疗（BRT）的安全性和有效性。

A comprehensive search was performed in databases from inception to October 2024.

我们在数据库中从创建开始到2024年10月进行了全面的搜索。

We identified 18 studies encompassing 538 adult NHL patients who received BRT prior to commercial CART19.

我们确定了18项研究，涵盖了538名在商业CART19之前接受BRT治疗的成年NHL患者。

Random-effect models were applied to explore meta- analysis outcomes.

应用随机效应模型来探索荟萃分析的结果。

Diffuse large B-cell lymphoma was the most common diagnosis (73%), and axicabtagene ciloleucel was the most utilized product (67%).

弥漫大B细胞淋巴瘤是最常见的诊断（73%），而axicabtagene ciloleucel是最常用的产品（67%）。

Bulky disease was present in 37%.

37%的患者存在肿块性疾病。

The median dose of BRT was 30 Gy delivered comprehensively to all sites of positron emission tomography-avid disease in 76% of cases.

BRT的中位剂量为30 Gy，76%的病例中全面照射到所有正电子发射断层扫描（PET）显像阳性的病变部位。

The overall response rate to CART19 was 78.9%.

CART19的总反应率为78.9%。

At 1 year, the progression-free survivalwas 54.6% while overall survivalwas 71.2%.

在1年时，无进展生存率为54.6%，总生存率为71.2%。

All-grade cytokine release syndrome (CRS) developed in 80% of cases while all-grade immune effector cell-associated neurotoxicity syndrome (ICANS) occurred in 39.4%.

所有级别的细胞因子释放综合征（CRS）在80%的病例中发生，而所有级别的免疫效应细胞相关神经毒性综合征（ICANS）在39.4%的病例中出现。

The rate of grade 3/4 CRS was 3.6%, while that of grade 3/4 ICANS was 10.6%.

3/4级细胞因子释放综合征（CRS）的发生率为3.6%，而3/4级免疫效应细胞相关神经综合征（ICANS）的发生率为10.6%。

Sensitivity analyses including studies with bulky disease and excluding studies with patients who also received systemic bridging therapy, demonstrated consistent results compared to the main study findings.

包括大体积疾病的研究和排除同时接受系统桥接治疗的患者的研究的敏感性分析，与主要研究结果相比，显示出一致的结果。

Subgroup meta-regression showed similar results in studies that utilized BRT only compared to studies that utilized combined-modality treatment.

亚组元回归分析显示，仅使用BRT的研究与采用综合治疗模式的研究结果相似。

In conclusion, this meta-analysisfound that BRT use prior to CART19, whether as a standalone approach or in combination with systemic therapy, does not increase toxicity or compromise the efficacy of CART19 therapy in NHL.

总之，这项荟萃分析发现，在CART19治疗前使用BRT，无论是作为独立方法还是与全身治疗相结合，都不会增加毒性或降低CART19治疗在非霍奇金淋巴瘤中的疗效。

Furthermore, the use of BRT is associated with a low rate of CRS, even in patients with bulky disease.

此外，使用BRT与低的细胞因子释放综合征（CRS）发生率相关，即便是在有大量疾病的患者中也是如此。