Gefitinib Combined With Radiation Therapy For Patients With Brain Metastases From Non-small Cell Lung Cancer:A Meta-analysis

Objective:Meta analysis was used to evaluate the effect and side effects of gefitinib combined with radiotherapy in the treatment of non-small cell lung cancer with brain metastases,so as to provide good decisions and scientific basis for medical diagnosis and treatment.Methods:The electronic databases include PubMed ? Cochrane Library ?Embase ? Wanfang medical network,CNKI and China biomedical literature database from inception to December 2017.At the same time,we searched related conference papers and collected relevant unpublished papers by artificial retrieval method.According to the inclusion criteria and exclusion criteria,we screened and collected relevant Chinese and English literatures about gefitinib combined with radiotherapy for non-small cell lung cancer brain metastases.The quality of the included literature was evaluated with Newcastle Ottawa scale(NOS),and the Revman 5.3 software was used for Meta analysis,and the publication bias analysis were carried out.Results:There were a total of 10 studies including 733 patients,of which 285 were in group Gefitinib+RT and 448 in group RT alone.The results ofMeta analysis showed that radiotherapy combined with gefitinib,ORR of treatment group(0R=2.27,95%CI:[1.61,3.21],P<0.00001),DCR(0R=2.92,95%CI:[1.95,4.37],P<0.00001),the 1 year overall survival rate(0R=2.36,95%CI:[1.36,4.11],P=0.002)were significantly higher than those of the radiotherapy group,and the differe nce was statistically significant.In terms of side effects,the patients in the combined treatment group had a higher risk for the occurrence of rash than the radiotherapy group,(0R=5.04,95%CI:[1.24,20.51],P=0.02)and the other side effects including nausea,diarrhea,fatigue,granulocyte decline between two groups were not statistically significant(P>0.05).Conclusion:For the patients of non small cell lung cancer with brain metastases,objective response rate,disease control rate and 1 year survival rate of the patients treated with radiotherapy combined with gefitinib were significantly higher than that of radiotherapy group.The probability of a rash side effect in the combined treatment group is higher,but the other adverse reactions did not increase significantly,and these adverse reactions are in a controlled and acceptable range.