Epidermal growth factor receptor tyrosine kinase inhibitors combined with thoracic radiotherapy or chemoradiotherapy for advanced or metastatic non-small cell lung cancer: A systematic review and meta-analysis of single-arm trials

摘要: Background Preclinical in vitro experiments demonstrated that epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) might have synergistic effect combination with radiotherapy on Non-small cell lung cancer (NSCLC), but the clinical trials showed inconsistence results NSCLC patients EGFR status unknow or mutations. This study aimed to determine if added TKIs Thoracic (TRT) improve primary disease response rate (RR) and survival outcomes advanced metastatic NSCLC. Methods We searched MEDLINE, EMBASE, Cochrane Library from January 2000 December 2017 for eligible studies where received concurrent TRT CRT. Concerned were tumor RR, overall (OS), adverse events (AEs). The meta-analysis was performed using Stata software (version 12.0). Random effects models used pool across studies. Sensitivity analysis would be different. Results found 16 prospective mature meta-analyses. Twelve including 446 reported RR of combined TKIs. CR, PR, SD, PD, respectively, 0.06 (95% CI 0.03-0.09, I = 0%), 0.44 0.38-0.49, 64.9%), 0.29 0.24-0.34, 78.4%), 0.15 0.11-0.19, 84.2%). One- 2-year OS, 0.52 0.44-0.60, 38.8%) 0.26 0.18-0.33, 0%). Four 182 CRT pooled 0.12 0.02-0.22, 69.1%), 0.41 0.27-0.55, I71.6%), 0.31 0.16-0.46, 79%), 0.14 -0.01-0.30, 87.8%). Only 1 event rate, 1- 0.83 0.71-0.94) 0.67 0.54-0.81). There not severe (SAEs) either Conclusion is evidence, albeit low quality, may mutant unknown relative other alone, alone