PMID- 30032006
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1936-5233 (Print)
IS  - 1936-5233 (Electronic)
IS  - 1936-5233 (Linking)
VI  - 11
IP  - 5
DP  - 2018 Oct
TI  - Efficacy and Safety of Radiotherapy Plus EGFR-TKIs in NSCLC Patients with Brain 
      Metastases: A Meta-Analysis of Published Data.
PG  - 1119-1127
LID - S1936-5233(18)30195-5 [pii]
LID - 10.1016/j.tranon.2018.07.003 [doi]
AB  - BACKGROUND: The role of radiotherapy (RT) combined with epidermal growth factor 
      receptor tyrosine kinase inhibitors (EGFR-TKIs) in non-small cell lung cancer 
      (NSCLC) patients with brain metastasis (BM) remains controversial. Therefore, we 
      conducted a meta-analysis to comprehensively evaluate the efficacy and safety of 
      RT plus EGFR-TKIs in those patients. MATERIALS AND METHODS: Relevant literatures 
      published between 2012 and 2017 were searched. Objective response rate(ORR), 
      disease control rate (DCR), overall survival (OS), intracranial progression-free 
      survival (I-PFS) and adverse events (AEs) were extracted. The combined hazard 
      ratios (HRs) and relative risks (RRs) were calculated using random effects 
      models. RESULTS: Twenty-four studies (2810 patients) were included in the 
      analysis. Overall, RT plus EGFR-TKIs had higher ORR (RR = 1.32, 95%CI: 
      1.13-1.55), DCR (RR = 1.12, 95%CI: 1.04-1.22), and longer OS (HR = 0.72, 95%CI: 
      0.59-0.89), I-PFS (HR = 0.64, 95%CI: 0.50-0.82) than monotherapy, although with 
      higher overall AEs (20.2% vs 11.8%, RR = 1.34, 95% CI: 1.11-1.62). Furthermore, 
      subgroup analyses found concurrent RT plus EGFR-TKIs could prolong OS (HR = 0.69, 
      95%CI: 0.55-0.86) and I-PFS (HR = 0.57, 95%CI: 0.44-0.75). Asian ethnicity and 
      lung adenocarcinoma (LAC) patients predicted a more favorable prognosis 
      (HR = 0.69,95%CI: 0.54-0.88, HR = 0.66, 95%CI: 0.53-0.83, respectively). 
      CONCLUSION: RT plus EGFR-TKIs had higher response rate, longer OS and I-PFS than 
      monotherapy in NSCLC patients with BM. Asian LAC patients with EGFR mutation had 
      a better prognosis with concurrent treatment. The AEs of RT plus EGFR-TKIs were 
      tolerated.
CI  - Copyright (c) 2018 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Wang, Xueyan
AU  - Wang X
AD  - Department of Oncology, The First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, Jiangsu, 210029, China.
FAU - Xu, Ye
AU  - Xu Y
AD  - Department of Oncology, The First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, Jiangsu, 210029, China.
FAU - Tang, Weiqing
AU  - Tang W
AD  - Division of Surgery, Guilin Medical University, Guilin, Guangxi, 541000, China.
FAU - Liu, Lingxiang
AU  - Liu L
AD  - Department of Oncology, The First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, Jiangsu, 210029, China. Electronic address: llxlau@163.com.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20180720
PL  - United States
TA  - Transl Oncol
JT  - Translational oncology
JID - 101472619
PMC - PMC6074003
EDAT- 2018/07/23 06:00
MHDA- 2018/07/23 06:01
PMCR- 2018/07/20
CRDT- 2018/07/23 06:00
PHST- 2018/05/08 00:00 [received]
PHST- 2018/06/29 00:00 [revised]
PHST- 2018/07/02 00:00 [accepted]
PHST- 2018/07/23 06:00 [pubmed]
PHST- 2018/07/23 06:01 [medline]
PHST- 2018/07/23 06:00 [entrez]
PHST- 2018/07/20 00:00 [pmc-release]
AID - S1936-5233(18)30195-5 [pii]
AID - 10.1016/j.tranon.2018.07.003 [doi]
PST - ppublish
SO  - Transl Oncol. 2018 Oct;11(5):1119-1127. doi: 10.1016/j.tranon.2018.07.003. Epub 
      2018 Jul 20.