Meta-analysis On Clinical Effect And Safety In Treating Advanced Non-small Cell Lung Cancer Between Multitargeted Tyrosine Kinaseinhibitors Combined With Chemotherapy And Chemotherapy Alone

Objective To evaluate the clinical effect and safety in treating advanced non-small cell lung cancer between multitargeted tyrosine kinase inhibitors combined with chemotherapy and chemotherapy alone.Methods Databases including The Cochrane Library,PubMed,EMbase,American Society of Clinical Oncology(ASCO),European Society for Medical Oncology(ESCO),Medline were searched to collect randomized controlled trials(RCTs)about multitargeted tyrosine kinaseinhibitors combined with chemotherapy and chemotherapy alone for NSCLC from inception to December 2016.Two reviewers independently screened literature and extracted data.If the opinion is not unified,then discuss each other to solve or seek the views of the third researcher.The method of quality evaluation and meta-analysis of the literature were carried out by RevMan5.3software.Results A total of 12 RCTs involving 6559 patients were finally included.The results of meta-analysis showed that:1.Main survival indicators:(1)the median progression free survival(HR =0.86,95%CI(0.81,0.91),P<0.001)and objective response rate(HR=1.43,95%CI(1.20,1.70),P<0.001)of test group were statistically significantly longer than those of control group.(2)There were no statistically significant differences in the median survival time(HR = 0.91,95% CI(0.82,1.00),P = 0.06).2.Major adverse reactions:(1)the incidence of neutrocytopenia(RR= 1.16,95% CI(1.05,1.28),P=0.003),thrombocytopenia(RR=1.46,95% CI(1.23,1.73),P<0.001)and diarrhea(RR=2.07,95% CI(1.81,2.37),P<0.001)of test group was statistically significantly higher than that of control group.(2)The incidence of anemia(RR = 0.84,95% CI(0.74,0.95),P = 0.006)was lower than that of control group.(3)There were no significant differences between two groups in incidence of fatigue(RR=1.03,95% CI(0.97,1.11),P=0.33)and dyspnea(RR=1.01,95% CI(0.91,1.13),P=0.82).Conclusion In terms of efficacy,compared with chemotherapy alone multitargeted tyrosine kinaseinhibitors combined with chemotherapy can improve the median progression free survival and objective response rate.In terms of safety,compared with chemotherapy alone multitargeted tyrosine kinaseinhibitors combined with chemotherapy had a higher incidence of neutropenia,thrombocytopenia and diarrhea,but did not affect the patient's ultimate survival.In summary,multi-target tyrosine kinase inhibitors combined with chemotherapy can be a way to improve the quality of life of patients with advanced NSCLC.