Efficacy and Safety of Radiotherapy Combined with Immunotherapy for Brain Metastases from Lung Cancer: A Meta-analysis
Background and objective Immunotherapy (IT) is recommended for the treatment of advanced non-small cell lung cancer (NSCLC), while brain radiotherapy (RT) is the mainstream treatment for patients with brain metastases (BM). This study aimed to investigate the efficacy and safety of combined use of R...
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| Format: | Article |
| Language: | zho |
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Chinese Anti-Cancer Association; Chinese Antituberculosis Association
2022-10-01
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| Series: | Chinese Journal of Lung Cancer |
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| Online Access: | http://www.lungca.org/index.php?journal=01&page=article&op=view&path%5B%5D=10.3779%2Fj.issn.1009-3419.2022.101.48 |
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| author | Lijuan XU Yingtai CHEN Mei WANG |
| author_facet | Lijuan XU Yingtai CHEN Mei WANG |
| author_sort | Lijuan XU |
| collection | DOAJ |
| description | Background and objective Immunotherapy (IT) is recommended for the treatment of advanced non-small cell lung cancer (NSCLC), while brain radiotherapy (RT) is the mainstream treatment for patients with brain metastases (BM). This study aimed to investigate the efficacy and safety of combined use of RT and IT. Methods The date was limited to May 1, 2022, and literature searches were carried out in CNKI, Wanfang, PubMed, EMBASE and Cochrane databases. Heterogeneity was judged using the I2 test and P value. Publication bias was assessed using a funnel plot. The quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS). Statistical analysis was performed using Stata 16.0 software. Results A total of 17 articles involving 2,636 patients were included. In the comparison of RT+IT group and RT group, no significant difference was found in overall survival (OS) (HR=0.85, 95%CI: 0.52-1.38, I2=73.9%, Pheterogeneity=0.001) and intracranial distance control (DBC) (HR=1.04, 95%CI: 0.55-1.05, I2=80.5%, Pheterogeneity<0.001), but the intracranial control (LC) in the RT+IT group was better than the RT group (HR=0.46, 95%CI: 0.22-0.94, I2=22.2%, Pheterogeneity=0.276), and the risk of radiation necrosis/treatment-related imaging changes (RN/TRIC) was higher than RT (HR=1.72, 95%CI: 1.12-2.65, I2=40.2%, Pheterogeneity=0.153). In the comparison between the RT+IT concurrent group and the sequential group, no significant difference was found in OS (HR=0.62, 95%CI: 0.27-1.43, I2=74.7%, Pheterogeneity=0.003) and RN/TRIC (HR=1.72, 95%CI: 0.85-3.47, I2=0%, Pheterogeneity=0.388) was different between the two groups. However, DBC in the concurrent treatment group was better than that in the sequential treatment group (HR=0.77, 95%CI: 0.62-0.96, I2=80.5%, Pheterogeneity<0.001). Conclusion RT combined with IT does not improve the OS of NSCLC patients with BM, but also increases the risk of RN/TRIC. In addition, compared with sequential RT and IT, concurrent RT and IT improved the efficacy of DBC. |
| first_indexed | 2024-04-11T08:23:30Z |
| format | Article |
| id | doaj.art-7788c54c01f34dd4924ef653cb10ad28 |
| institution | Directory Open Access Journal |
| issn | 1009-3419 1999-6187 |
| language | zho |
| last_indexed | 2024-04-11T08:23:30Z |
| publishDate | 2022-10-01 |
| publisher | Chinese Anti-Cancer Association; Chinese Antituberculosis Association |
| record_format | Article |
| series | Chinese Journal of Lung Cancer |
| spelling | doaj.art-7788c54c01f34dd4924ef653cb10ad282022-12-22T04:34:50ZzhoChinese Anti-Cancer Association; Chinese Antituberculosis AssociationChinese Journal of Lung Cancer1009-34191999-61872022-10-01251071572210.3779/j.issn.1009-3419.2022.101.48Efficacy and Safety of Radiotherapy Combined with Immunotherapy
for Brain Metastases from Lung Cancer: A Meta-analysisLijuan XU0Yingtai CHEN1Mei WANG2Department of Outpatients, Suzhou Ninth People’s Hospital, Suzhou 215200, ChinaDepartment of Thoracic Surgery, Beijing Aerospace General Hospital, Beijing 100076, ChinaDepartment of Marketing, Beijing Aerospace General Hospital, Beijing 100076, ChinaBackground and objective Immunotherapy (IT) is recommended for the treatment of advanced non-small cell lung cancer (NSCLC), while brain radiotherapy (RT) is the mainstream treatment for patients with brain metastases (BM). This study aimed to investigate the efficacy and safety of combined use of RT and IT. Methods The date was limited to May 1, 2022, and literature searches were carried out in CNKI, Wanfang, PubMed, EMBASE and Cochrane databases. Heterogeneity was judged using the I2 test and P value. Publication bias was assessed using a funnel plot. The quality of included studies was assessed using the Newcastle-Ottawa Scale (NOS). Statistical analysis was performed using Stata 16.0 software. Results A total of 17 articles involving 2,636 patients were included. In the comparison of RT+IT group and RT group, no significant difference was found in overall survival (OS) (HR=0.85, 95%CI: 0.52-1.38, I2=73.9%, Pheterogeneity=0.001) and intracranial distance control (DBC) (HR=1.04, 95%CI: 0.55-1.05, I2=80.5%, Pheterogeneity<0.001), but the intracranial control (LC) in the RT+IT group was better than the RT group (HR=0.46, 95%CI: 0.22-0.94, I2=22.2%, Pheterogeneity=0.276), and the risk of radiation necrosis/treatment-related imaging changes (RN/TRIC) was higher than RT (HR=1.72, 95%CI: 1.12-2.65, I2=40.2%, Pheterogeneity=0.153). In the comparison between the RT+IT concurrent group and the sequential group, no significant difference was found in OS (HR=0.62, 95%CI: 0.27-1.43, I2=74.7%, Pheterogeneity=0.003) and RN/TRIC (HR=1.72, 95%CI: 0.85-3.47, I2=0%, Pheterogeneity=0.388) was different between the two groups. However, DBC in the concurrent treatment group was better than that in the sequential treatment group (HR=0.77, 95%CI: 0.62-0.96, I2=80.5%, Pheterogeneity<0.001). Conclusion RT combined with IT does not improve the OS of NSCLC patients with BM, but also increases the risk of RN/TRIC. In addition, compared with sequential RT and IT, concurrent RT and IT improved the efficacy of DBC.http://www.lungca.org/index.php?journal=01&page=article&op=view&path%5B%5D=10.3779%2Fj.issn.1009-3419.2022.101.48radiotherapy combined with immunotherapy; efficacy; safety; brain metastases; lung neoplasms; meta-analysis |
| spellingShingle | Lijuan XU Yingtai CHEN Mei WANG Efficacy and Safety of Radiotherapy Combined with Immunotherapy for Brain Metastases from Lung Cancer: A Meta-analysis Chinese Journal of Lung Cancer radiotherapy combined with immunotherapy; efficacy; safety; brain metastases; lung neoplasms; meta-analysis |
| title | Efficacy and Safety of Radiotherapy Combined with Immunotherapy
for Brain Metastases from Lung Cancer: A Meta-analysis |
| title_full | Efficacy and Safety of Radiotherapy Combined with Immunotherapy
for Brain Metastases from Lung Cancer: A Meta-analysis |
| title_fullStr | Efficacy and Safety of Radiotherapy Combined with Immunotherapy
for Brain Metastases from Lung Cancer: A Meta-analysis |
| title_full_unstemmed | Efficacy and Safety of Radiotherapy Combined with Immunotherapy
for Brain Metastases from Lung Cancer: A Meta-analysis |
| title_short | Efficacy and Safety of Radiotherapy Combined with Immunotherapy
for Brain Metastases from Lung Cancer: A Meta-analysis |
| title_sort | efficacy and safety of radiotherapy combined with immunotherapy
for brain metastases from lung cancer a meta analysis |
| topic | radiotherapy combined with immunotherapy; efficacy; safety; brain metastases; lung neoplasms; meta-analysis |
| url | http://www.lungca.org/index.php?journal=01&page=article&op=view&path%5B%5D=10.3779%2Fj.issn.1009-3419.2022.101.48 |
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