title: [Whole brain radiation therapy plus temozolomide in the treatment of brain metastases from non small cell lung cancer: a meta-analysis].
abstract: OBJECTIVE
  To explore the efficacy and safety of whole brain radiation therapy (WBRT) plus temozolomide (TMZ) versus WBRT alone in the treatment of brain metastases from non-small cell lung cancer (NSCLC) through a meta-analysis.
  
  
  METHODS
  All previously published and some unpublished studies were comprehensively searched from the databases of MEDLINE, EMBASE, Cochrane Library and CBM, etc. The meta-analysis included all randomized controlled trials (RCTs) to compare WBRT plus TMZ with WBRT alone in treatment of brain metastases from NSCLC. The primary meta-analysis was based upon objective remission (OR) and toxicity and the second overall survival (OS).
  
  
  RESULTS
  Four RCTs identified by two reviewers were included. There was significant improvement for the WBRT + TMZ group in OR rate (RR = 1.55, P = 0.003); but without significant improvement in OS (P = 0.69). Meanwhile, WHO grade III/IV hematologic toxicity of myelosuppression increased in the WBRT + TMZ group (RR = 2.47, P = 0.008), but without significant difference in gastrointestinal toxicity (P = 0.14).
  
  
  CONCLUSIONS
  For the treatment of brain metastases from NSCLC, the combined therapy of WBRT plus TMZ improves OR, but without significant improvement in OS. And the incidence of myelosuppression is elevated. Future large-scale, high-quality and prospective phase III RCTs are needed to confirm the clinical efficacy and safety of WBRT plus TMZ.
authors: Department of Radiotherapy, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
authors: Kai
authors: K
authors: Liao
authors: Zhuo-fei
authors: ZF
authors: Bi
authors: Yan
authors: Y
authors: He
authors: Yi-min
authors: YM
authors: Liu
mesh_terms: D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D000077204:Temozolomide
chemical_list: D003606:Dacarbazine; D000077204:Temozolomide