title: Evaluation on efficacy and safety of tyrosine kinase inhibitors plus radiotherapy in NSCLC patients with brain metastases.
abstract: OBJECTIVE
  The study was designed to evaluate the efficacy and safety of tyrosine kinase inhibitors (TKIs) plus radiotherapy in patients with brain metastases (BM) of non-small cell lung cancer.
  
  
  METHODS
  Medline PubMed, Google Scholar, Web of Science, Oxford Journals Collection, clinical trials and current controlled trials were searched to identify relevant publications. After screening literature and undertaking quality assessment and data extraction, the meta-analysis was performed using RevMan5.3 software.
  
  
  RESULTS
  Eight controlled trials (980 participants) were included in the study. Compared with radiotherapy without TKIs (non-TKI-group), TKIs plus radiotherapy (TKI-group) had a significant benefit on objective response rate (ORR) (RR = 1.56, 95%CI [1.25,2.03]; P =0.0008), significantly prolonged the time to central nerves system progression (CNS-TTP) (HR =0.58, 95% CI [0.35, 0.96]; P =0.03) and median overall survival (MOS) (HR =0.68, 95% CI [0.47, 0.98]; P =0.04) of NSCLC patients with BM. There was no significant difference in overall severe adverse events (Grade≥3) (RR = 1.49, 95% CI [0.88,2.54]; P = 0.14) between two groups.
  
  
  CONCLUSIONS
  This meta-analysis showed TKI-group produced superior response rate when compared with non-TKI-group. TKIs plus radiotherapy significantly prolong the CNS-TTP and MOS of patients without enhancing overall severe adverse events.
authors.affiliation: Department of Chemotherapy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors.forename: Shuimei
authors.initials: S
authors.lastname: Luo
authors.affiliation: Intensive Care Unit, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors.forename: Long
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Oncology, Fuzhou Pulmonray Hospital, Fuzhou, Fujian, China.
authors.forename: Xiuping
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Chemotherapy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors.forename: Xianhe
authors.initials: X
authors.lastname: Xie
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000532:radiotherapy*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D000069347:Erlotinib Hydrochloride / Q000627:therapeutic use; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D008297:Male; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011799:Quinazolines / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; C512478:EGFR protein, human; D066246:ErbB Receptors; D011505:Protein-Tyrosine Kinases; D000077156:Gefitinib
keywords: brain metastasis; chemotherapy; non-small cell lung cancer; radiotherapy; tyrosine kinase inhibitor