title: Combining Whole-Brain Radiotherapy with Gefitinib/Erlotinib for Brain Metastases from Non-Small-Cell Lung Cancer: A Meta-Analysis.
abstract: BACKGROUND
  To comprehensively assess the efficacy and safety of whole-brain radiotherapy (WBRT) combined with gefitinib/erlotinib for treatment of brain metastases (BM) from non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  Databases including PubMed, EMBASE.com, Web of Science, and Cochrane Library were searched from inception to April 12, 2015. Studies on randomized controlled trials (RCTs) and case-control trials comparing WBRT combined with gefitinib/erlotinib versus WBRT alone for BM from NSCLC were included. Literature selection, data extraction, and quality assessment were performed independently by two trained reviewers. RevMan 5.3 software was used to analyze data.
  
  
  RESULTS
  A total of 7 trials involving 622 patients were included. Compared with WBRT alone or WBRT plus chemotherapy, WBRT plus gefitinib/erlotinib could significantly improve response rate (OR = 2.16, 95% CI: 1.35-3.47; P = 0.001), remission rate of central nervous system (OR = 6.06, 95% CI: 2.57-14.29; P < 0.0001), disease control rate (OR = 3.34, 95% CI: 1.84-6.07; P < 0.0001), overall survival (HR = 0.72, 95% CI: 0.58-0.89; P = 0.002), and 1-year survival rate (OR = 2.43, 95% CI: 1.51-3.91; P = 0.0002). In adverse events (III-IV), statistically significant differences were not found, except for rash (OR = 7.96, 95% CI: 2.02-31.34; P = 0.003) and myelosuppression (OR = 0.19, 95% CI: 0.07-0.51; P = 0.0010).
  
  
  CONCLUSIONS
  WBRT plus gefitinib/erlotinib was superior to WBRT alone and well tolerated in patients with BM from NSCLC.
authors.affiliation: Department of Neurosurgery, First Clinical Medical College of Lanzhou University, Lanzhou 730000, China; Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China.
authors.forename: Mao-hua
authors.initials: MH
authors.lastname: Zheng
authors.affiliation: Department of Neurosurgery, Affiliated Hospital, Medical College of Chinese People's Armed Police, Tianjin 300162, China.
authors.forename: Hong-tao
authors.initials: HT
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, First Clinical Medical College of Lanzhou University, Lanzhou 730000, China.
authors.forename: Ji-guang
authors.initials: JG
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, First Clinical Medical College of Lanzhou University, Lanzhou 730000, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, First Clinical Medical College of Lanzhou University, Lanzhou 730000, China.
authors.forename: Lei-ming
authors.initials: LM
authors.lastname: Huo
authors.affiliation: Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China.
authors.forename: Pan
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China.
authors.forename: Jin-hui
authors.initials: JH
authors.lastname: Tian
authors.affiliation: Evidence-Based Medicine Center of Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China.
authors.forename: Ke-hu
authors.initials: KH
authors.lastname: Yang
mesh_terms: D001932:Brain Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D000069347:Erlotinib Hydrochloride / Q000627:therapeutic use*; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D009362:Neoplasm Metastasis; D011799:Quinazolines / Q000627:therapeutic use*
chemical_list: D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib