Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Whole Brain Radiotherapy Plus Chemotherapy in the Treatment of Brain Metastases from Lung Cancer: A Meta-analysis of 19 Randomized Controlled Trails

  • Liu, Wen-Jing (Department of Pulmonary Neoplasms Internal Medicine, Affiliated Hospital of Academy of the Military Medical Sciences) ;
  • Zeng, Xian-Tao (Department of Stomatology, Taihe Hospital, Hubei University of Medicine) ;
  • Qin, Hai-Feng (Department of Pulmonary Neoplasms Internal Medicine, Affiliated Hospital of Academy of the Military Medical Sciences) ;
  • Gao, Hong-Jun (Department of Pulmonary Neoplasms Internal Medicine, Affiliated Hospital of Academy of the Military Medical Sciences) ;
  • Bi, Wei-Jing (Department of Respiratory Medicine, General Hospital of Sichuan Petroleum) ;
  • Liu, Xiao-Qing (Department of Pulmonary Neoplasms Internal Medicine, Affiliated Hospital of Academy of the Military Medical Sciences)
  • Published : 2012.07.31
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Abstract

Objective: To evaluate the efficacy and safety of whole brain radiotherapy (WBRT) plus chemotherapy versus WBRT alone for treating brain metastases (BM) from lung cancer by performing a meta-analysis based on randomized controlled trials (RCTs). Methods: The PubMed, Embase, CENTRAL, ASCO, ESMO, CBM, CNKI, and VIP databases were searched for relevant RCTs performed between January 2000 and March 2012. After quality assessment and data extraction, the meta-analysis was performed using the RevMan 5.1 software, with funnel plot evaluation of publication bias. Results: 19 RCTs involving 1,343 patients were included. The meta-analyses demonstrated that compared to WBRT alone, WBRT plus chemotherapy was more effective with regard to the objective response rate (OR = 2.30, 95% CI = 1.79 - 2.98; P < 0.001); however, the incidences of gastrointestinal reactions (RR = 3.82, 95% CI = 2.33 - 6.28, P <0.001), bone marrow suppression (RR = 5.49, 95% CI = 3.65 - 8.25, P < 0.001), thrombocytopenia (RR = 5.83, 95% CI = 0.39 - 86.59; P = 0.20), leukopenia (RR = 3.13, 95% CI = 1.77 - 5.51; P < 0.001), and neutropenia (RR = 2.75, 95% CI = 1.61 - 4.68; P < 0.001) in patients treated with WBRT plus chemotherapy were higher than with WBRT alone. There was no obvious publication bias detected. Conclusion: WBRT plus chemotherapy can obviously improve total efficacy rate, butalso increases the incidence of adverse reactions compared to WBRT alone. From the limitations of this study, more large-scale, high-quality RCTs are suggested for further verification.

Keywords

References

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