Open AccessMeta‐analysis of whole‐brain radiotherapy plus temozolomide compared with whole‐brain radiotherapy for the treatment of brain metastases from non‐small‐cell lung cancer
Author(s) -
Xin Yong,
Guo WenWen,
Yang Chun Sheng,
Huang Qian,
Zhang Pei,
Zhang Long Zhen,
Jiang Guan
Publication year - 2018
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.1306
Subject(s) - medicine , whole brain radiotherapy , temozolomide , adverse effect , lung cancer , relative risk , confidence interval , radiation therapy , oncology , headaches , meta analysis , brain metastasis , randomized controlled trial , cancer , surgery , metastasis
The aim of this meta‐analysis was to compare the efficiency of whole‐brain radiotherapy (WBRT) plus temozolomide (TMZ) with WBRT for the treatment of brain metastases from non‐small‐cell lung cancer (NSCLC). For dichotomous variables, outcomes were reported as relative risk ratio (RR) and 95% confidence interval (CI) was used to investigate the following outcome measures: overall response rate, headache, gastrointestinal adverse reactions, and hematological adverse reactions. Twelve randomized controlled trials involving 925 participants (480 received WBRT plus TMZ; 445 received WBRT) were included in the meta‐analysis. There was a significant difference between the overall response rate (RR = 1.40, 95% CI 1.24–1.57; Z = 5.51; P < 0.00001), gastrointestinal adverse reactions (RR = 1.46, 95% CI 1.05–2.04; Z = 2.27; P = 0.02), and hematological adverse reactions (RR = 1.45, 95% CI 1.04–2.02; Z = 2.21; P = 0.03) of patients treated with WBRT plus TMZ compared with patients treated with WBRT alone. There was no significant difference between headaches (RR = 1.11, 95% CI 0.93–1.02; Z = 1.13; P = 0.26) in patients treated with WBRT plus TMZ compared with patients treated with WBRT alone. In conclusion, the currently available evidence shows that WBRT plus TMZ increases the overall response rate in patients with brain metastases of NSCLC compared with WBRT alone.