Efficacy and safety of WBRT+EGFR‐TKI versus WBRT only in the treatment of NSCLC patients with brain metastasis: An updated meta‐analysis

Abstract

Abstract Background To investigate the efficacy and safety of whole brain radiotherapy (WBRT) combined with epidermal growth factor receptor‐tyrosine kinase inhibitor (EGFR‐TKI) versus WBRT only in the treatment of brain metastasis in non‐small cell lung cancer (NSCLC) patients by pooling open published data. Methods Prospective clinical studies relevant to WBRT+EGFR‐TKI versus WBRT only in the treatment of NSCLC brain metastasis were electronically searched in the Pubmed, EMbase, Cochrane, Wangfang, CNKI and Google scholar databases. The treatment response, 1‐year survival and treatment‐associated toxicity were pooled and expressed by odds ratio (OR) under a fixed or random effect model. The publication bias was evaluated by Begg's funnel plot and Egger's line regression test. Results Eighteen prospective clinical studies were included in the study. The combined results indicated that the objective response rate (ORR) in the WBRT+TKI group was superior to WBRT only with a statistical difference (OR = 2.67, 95% CI: 2.10–3.38, p 0.05), diarrhea (OR = 1.31, 95% CI: 0.83–2.07, p > 0.05), fatigue (OR = 1.40, 95% CI: 0.70–2.81, p > 0.05) and myelosuppression (OR = 0.86, 95% CI: 0.56–1.32, p > 0.05) were not statistically different between the two groups. Conclusions Based on the current publications, WBRT+EGFR‐TKI can improve the treatment response and 1‐year survival rate but not increase the toxicity except for rash compared to WBRT alone in the treatment of brain metastasis in NSCLC patients.

Keywords

• epidermal growth factor receptor‐tyrosine kinase inhibitor
• meta‐analysis
• non‐small cell lung cancer
• whole brain radiotherapy