Evaluation On Efficacy And Safety Of Radiotherapy Plus EGFR-TKIs In Non Small Cell Lung Cancer With Brain Metastasis: A Meta Analysis

Objective: To evaluate the efficacy and safety of radiotherapy plus EGFR-TKIs contrasted with radiotherapy in non small cell lung cancer with brain metastasis by meta analysis.Method: Pubmed,Embase,china biology medicine,CNKI,wanfang database etc were searched for the relevant publications.All relevant publications were persperctive randomized or non-randomized trials about radiotherapy plus EGFR-TKIs as treatment in non small cell lung cancer patients with brain metastasis.All the publications were screened by the inclusion and exclusion criteria strictly,then we undertake the quality assessment and data abstraction,finally the meta analysis were performed by using the Revman5.3 or the Stata12.0.The reliability of results were evaluated by sensitivity analysis and publication bais analysis.Results: Seven controlled trials were included in this study,including six randomized controlled trials and one non-randomized controlled trial. There were 254 patients and 245 petients in the radiotherapy plus EGFR-TKIs group and radiotherapy group respectively in total.The meta analysis indicates that the RT+EGFR-TKIs group had a significant benefit on objective response rate(ORR)(RR=1.82,95%CI:[1.47,2.26], P<0.00001), and also on disease control rate(DCR)(RR=1.30,95%CI:[1.17,1.45], P<0.00001),when compared with radiotherapy without EGFR-TKIs group. But there were no statistical difference in one year overall survival rate(RR=1.69,95%CI: [0.97,2.95],P=0.06),and median overall survival(m OS)(MSR=1.134, 95%CI:[0.653,1.969],P=0.656) between two groups. And the patients in the RT+EGFR-TKIs group had a higher risk for the occurrence of rash(RR=18.06,95% CI:[6.77,48.16],P<0.00001)and dirrahoea(RR=3.98,95%CI:[1.99,7.95],P<0.0001) than in the control group.Conclusion: Radiotherapy plus EGFR-TKIs treatment had a significant benefit on objective response rate and disease control rate in the non small cell lung cancer patients with brain metastasis,but showed no advantage in improving median overall survival and one year overall survival rate,when contrasted with radiotherapy treatment.And the patients who received the radiotherapy plus EGFR-TKIs treatment were more likely to suffer from the rash and dirrahoea.