Meta-analysis Of The Efficacy And Safety Of Radiotherapy Combined With Targeted Therapy And Concurrent Radiotherapy And Chemotherapy In The Treatment Of Brain Metastasis Of Non-small Cell Lung Cancer

Objective: To compare the safety and efficacy of radiotherapy combined with epidermal growth factor receptor tyrosine kinase inhibitor and radiotherapy combined with chemotherapy in the treatment of brain metastasis of non-small cell lung cancer by meta-analysis.Methods: A literature search was conducted among web of science,EMBASE,PubMed,Wanfang,VIP Chinese science and technology journal database,China Journal Full-text Database,CNKI and other electronic database.The retrieval deadline is October 22,2019.According to the inclusion and exclusion criteria,the research literature was selected.The Newcastle Ottawa scale was assessed to evaluate the quality of the literature.The objective response rate(ORR),progression free survival(PFS),total survival(OS)and adverse reactions of the study were evaluated by R-language statistical analysis.The data of each study were combined to calculate the combined 95% CI.The sensitivity of each study was analyzed to evaluate the meta-analysis results Stability.Results: A total of 839 patients were included in 10 literatures.The overall effective rate(ORR=65.69%,OR= 4.19,95% CI 3.07-5.73,P < 0.0001),disease control rate(DCR=85.29%,OR = 3.42,95% CI 2.28-5.12,P < 0.0001),1-year survival rate(1-year survival rate=66.18%,OR = 1.52,95% CI 1.05-2.19,P = 0.026)of the radiotherapy combined with chemotherapy group were higher than those of the radiotherapy combined with chemotherapy group.In terms of safety,the incidence of rash in radiotherapy combined with targeted therapy group was higher than that in radiotherapy combined with chemotherapy group,the incidence of myelosuppression was lower than that in radiotherapy combined with chemotherapy group,and in the other adverse reactions such as digestive system or liver function damage were not statistically significant(P > 0.05).Conclusion:Meta analysis showed that radiotherapy combined with targeted therapy was better than radiotherapy combined with chemotherapy in the treatment of brain metastasis of non-small cell lung cancer,which could improve the clinical efficacy and 1-year survival rate.The incidence of adverse reactions in the blood system is lower,the incidence of rash is higher,and there is no significant difference in adverse reactions of digestive system and liver function damage.