title: The Efficacy and Safety of Chemotherapy in Patients With Nonsmall Cell Lung Cancer and Interstitial Lung Disease: A PRISMA-Compliant Bayesian Meta-Analysis and Systematic Review.
abstract: Chemotherapy plays a critical and venturous role against the co-morbidity of nonsmall cell lung cancer and interstitial lung disease (NSCLC-ILD).We performed a Bayesian meta-analysis and systematic review to evaluate the safety and efficacy of the chemotherapy in NSCLC-ILD patients.EMBASE, PubMed, the Cochrane Central Register of Controlled Trials, and clinicaltrials.gov (up to January 2015).We included all study designs except case reports, all studies with NSCLC-ILD patients and all the possible chemotherapy regimens.Quality was assessed by a components approach. We derived summary estimates using Bayesian method through WinBUGS (version 1.4.3, MRC Biostatistics Unit, Cambridge, UK).Seven studies involving 251 patients with NSCLC-ILD were included in the meta-analysis. The treatment response (complete remission, 0; [partial remission, 39.1%; 95% credible interval [CrI], 32.6-45.7]; [stable disease, 36%; 95% CrI, 29.6-42.2]; [PD, 15.4%; 95% CrI, 11.3-19.8]; [nonevaluable, 6.4%; 95% CrI, 2.7-10.1]; [overall response rate, 41.3%; 95% CrI, 35.3-47.4]; [disease control rate, 77.7%; 95% CrI, 72.2-82.7]) were comparable to that of patients with NSCLC alone; the survival outcomes (median overall survival, median progression-free survival, and 1-year survival rate) were slightly worse, especially the lower 1-year survival rate. Platinum-based doublets as first-line chemotherapy may be related to higher incidence of acute exacerbation-ILD in first line chemotherapy (AE, 8.47%; 95% CrI, 5.04-12.6).The data selection bias and small patient number make the meta-analysis of treatment response and conclusions generated from these data inaccurate.The present meta-analysis suggests that chemotherapy might be an effective therapy for patients with NSCLC-ILD, but it might be associated with higher incidence of acute exacerbation.
authors.affiliation: From the Department of Oncology, General Hospital of Tianjin Medical University, Tianjin, P.R. China (YJC, DSZ); Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, P.R. China (LXC); Department of Respiration, General Hospital of Tianjin Medical University, Tianjin, P.R. China (MXH); Internal Medicine of Traditional Chinese Medicine Department, Jing'an District Central Hospital of Shanghai, Shanghai, P.R. China (TSZ); and Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China (ZRZ).
authors.forename: Yu Jie
authors.initials: YJ
authors.lastname: Chen
authors.forename: Ling Xiao
authors.initials: LX
authors.lastname: Chen
authors.forename: Mei Xiang
authors.initials: MX
authors.lastname: Han
authors.forename: Tian Song
authors.initials: TS
authors.lastname: Zhang
authors.forename: Zhi Rui
authors.initials: ZR
authors.lastname: Zhou
authors.forename: Dian Sheng
authors.initials: DS
authors.lastname: Zhong
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000188:drug therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000188:drug therapy; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome