- 作者：Wenhua Ma<sup>1sup> ; Na Li<sup>1sup> ; Yonghui An<sup>1sup> ; Changpeng Zhou<sup>1sup> ; Changwen Bo<sup>1sup> ; Guangyu Zhang<sup>2sup><sup> ; sup><sup>zhangguangyu151212@163.com" class="auth_mail" title="E-mail the corresponding authorsup>
- 关键词：Brain metastases ; Meta-analysis ; Radiotherapy ; Temozolomide
- 刊名：World Neurosurgery
- 出版年：2016
- 出版时间：August 2016
- 年：2016
- 卷：92
- 期：Complete
- 页码：197-205
- 全文大小：3764 K
sSec_2">Methods
spara0015">Literature was searched in the following databases: Cochrane Controlled Trials Register (CENTRAL), PubMed (1994–2015.10), CBM (1978–2015.10), CNKI (1994–2015.10), VIP (1994–2015.10), and WANFANG (1994–2015.10). Randomized clinical trials (RCTs) of temozolomide plus radiotherapy in comparison with radiotherapy alone were included in this review and meta-analysis. The quality of included literatures was assessed by the international Cochrane collaboration method, and meta-analysis was performed using RevMan 5.0 software.
sSec_3">Results
spara0020">Total 19 publications of RCTs were included, and there was no allocation concealment or blinding in any of them. Six of the 19 were multicenter RCTs. Overall response rate (ORR) was in favor of radiotherapy plus temozolomide (risk ratio [RR] = 1.35, 95% CI: 1.23–1.47). Subgroup analysis of non–small cell lung cancer (NSCLC) metastasis brain tumor also showed that ORR was in favor of radiotherapy plus temozolomide (RR = 1.38; 95% CI: 1.17–1.63). Progression-free survival (PFS) or overall survival rate, however, was not significantly different between the 2 treatment groups. In addition, incidence of side effect was significantly higher in the group of radiotherapy plus temozolomide than that of radiotherapy alone (HR = 2.03, 95% CI: 1.56–2.64).
sSec_4">Conclusion
spara0025">Addition of temozolomide to radiotherapy could increase ORR in brain metastatic tumors. However, it did not significantly improve PFS or OS in the patients with brain metastases but increased risk of drug-related toxicity.