Comparison Of The Efficacy And Safety Between Whole Brain Radiotherapy And Combined With Temozolomide In The Treatment Of Non-small Cell Lung Cancer With Brain Metastases: A Meta Analysis

Objective To compare the efficacy and safety between Whole Brain Radiotherapy and Combined with Temozolomide in the Treatment of Non-Small Cell Lung Cancer with Brain Metastases?Methods According to the retrieval strategy,the Chinese and English literatures before February 2018 were retrieved from EMbase,Cochrane,Pub Med,Wan Fang,VP Chinese sci-tech journal database(VIP)and Chinese knowledge network,and the target literature was selected according to the inclusion criteria and the exclusion criteria.3 researchers independently assessed the quality of the included studies and extracted data.The Rev Man 5.3 and STATA 12.0 software was used for statistical analysis.The objective remission rate(ORR),the total survival period(OS),the progression free survival(PFS),and the side effects of chemotherapy were evaluated.Results 17 trials involving 1082 patients were included.The results of Meta analysis showed that the objective response rate of WBRT+TMZ group was higher than that of the WBRT group(OR=2.45;95%CI:1.88-3.21;P< 0.001),the progression free survival was longer(MSR=1.329;95%CI:1.143-1.545;P<0.001),and the hematological toxicity(OR=3.44;95%CI:1.63-7.26;P < 0.05)and the gastric intestinal reaction(2.31;0.05)were more common.Their heterogeneities are within the acceptable range and their differences were statistically significant.The results of OS are meaningless because of the larger heterogeneity.There was no difference in the incidence of headache(OR=1.09;95%CI:0.76-1.57;P=0.64).Conclusion Compared with WBRT alone,WBRT combined with TMZ is beneficial to improve its short-term efficacy,But the blood toxicity and gastrointestinal reaction are more common,and there is no significant difference in the occurrence of headache.The benefit of long-term survival is not accurate.