title: [Radiotherapy concomitant with first-generation epidermal growth factor receptor tyrosine kinase inhibitors in the treatment of brain metastases from non small cell lung cancer: a meta-analysis].
abstract: OBJECTIVE
  To evaluate the efficacy of whole brain radiotherapy (WBRT) or/and stereotactic radiotherapy (SRT) concomitant with first-generation epidermal growth factor receptor tyrosine kinase inhibitors (TKI), like erlotinib and gefitinib, in the treatment of brain metastases from non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Comprehensive searches were performed in different databases, including EMBASE, MEDLINE and Cochrane Library, etc. All randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) comparing radiotherapy (RT) plus TKI with RT alone in the treatment of brain metastases from NSCLC were included for meta-analysis with Cochrane Collaboration's RevMan5. 2 software. The primary end-points were objective remission (OR), disease control (DC) and toxicity while the secondary end-point was overall survival (OS).
  
  
  RESULTS
  Three RCTs and one non-randomized controlled trial were selected and included for final analysis. The RT + TKI group had significant improvements in OR rate (RR = 1. 80, P <0. 01) and DC rate (RR = 1. 31, P <0. 01). Meanwhile, rash (RR = 14. 36, P = 0. 003) and diarrhea (RR = 3. 49, P = 0. 005) increased in the RT + TKI group. Yet there was no significant difference in nausea or vomiting (P = 0. 20).
  
  
  CONCLUSIONS
  For NSCLC with brain metastases, RT plus TKI could improve OR, DC and OS, but there was a higher incidence of rash and diarrhea. There fore future high-quality and prospective RCTs are warranted to confirm the clinical efficacy of RT plus TKI in the treatment of NSCLC with brain metastases.
authors.forename: Yanhui
authors.initials: Y
authors.lastname: Jiang
authors.forename: Zhuofei
authors.initials: Z
authors.lastname: Bi
authors.forename: Doudou
authors.initials: D
authors.lastname: Li
authors.forename: Yimin
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000970:Antineoplastic Agents; D001932:Brain Neoplasms; D002289:Carcinoma, Non-Small-Cell Lung; D059248:Chemoradiotherapy; D066246:ErbB Receptors; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms; D011446:Prospective Studies; D047428:Protein Kinase Inhibitors; D011799:Quinazolines
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; C512478:EGFR protein, human; D066246:ErbB Receptors; D000077156:Gefitinib