Abstract Objective To investigate the clinical effect of induction chemotherapy plus concurrent radiochemotherapy in the treatment of locally advanced non-small cell lung cancer (NSCLC) through a meta-analysis. Methods CBM, CNKI, Cochrane Library, PubMed, and EMbase were searched for the articles on comparison between induction chemotherapy plus concurrent radiochemotherapy and concurrent radiochemotherapy for patients with locally advanced NSCLC. According to the inclusion and exclusion criteria, the data on short-term outcome and survival were collected. A Meta-analysis was performed to evaluate the clinical effect of induction chemotherapy followed by concurrent radiochemotherapy. Results A total of 5 articles were included, which involved 845 patients. The results showed that the short-term outcome and the 2-and 3-year survival rates were similar between patients receiving induction chemotherapy plus concurrent radiochemotherapy and those receiving concurrent radiochemotherapy (OR=0.875, 95% CI 0.507-1.510, P=0.631;HR=0.770, 95% CI 0.515-1.151, P=0.203;HR=0.809, 95% CI 0.559-1.172, P=0.262), but the patients receiving induction chemotherapy plus concurrent radiochemotherapy showed a significantly higher incidence rate of grade ≥3 leukopenia than those receiving concurrent radiochemotherapy alone (OR=0.637, 95% CI 0.435-0.931, P=0.020). Conclusions Induction chemotherapy plus concurrent radiochemotherapy shows no significant advantages over concurrent radiochemotherapy alone in the short-term outcome and 2-and 3-year survival rates, but it significantly increases myelosuppression. Since there are few studies involving a limited number of cases included in this analysis, more multicenter randomized trials are needed to provide more detailed data and further clarify the clinical value of induction chemotherapy plus concurrent radiochemotherapy.
Corresponding Authors:
Wang Jun. Email:wangjunzr@163.com
Cite this article:
Jing Shaowu,Wang Jun,Cheng Yunjie et al. Clinical value of induction chemotherapy plus concurrent radiochemotherapy for locally advanced non-small cell lung cancer:a Meta analysis[J]. Chinese Journal of Radiation Oncology, 2016, 25(3): 239-243.
Jing Shaowu,Wang Jun,Cheng Yunjie et al. Clinical value of induction chemotherapy plus concurrent radiochemotherapy for locally advanced non-small cell lung cancer:a Meta analysis[J]. Chinese Journal of Radiation Oncology, 2016, 25(3): 239-243.
[1] Aupérin A,Le Péchoux C,Rolland E,et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer[J].J Clin Oncol,2010,28(13):2181-2190.DOI:10.1200/JCO.2009.26.2543. [2] Driesen P,Lambrechts M,Kraaij K,et al. A phase Ⅱ single-arm study of induction chemotherapy with cisplatin and gemcitabine followed by concurrent cisplatin and gemcitabine with thoracic radiation for unresectable locally advanced non-small cell lung cancer[J].Ther Adv Med Oncol,2013,5(3):159-168.DOI:10.1177/1758834013481021. [3] Lerouge D,Rivière A,Dansin E,et al. A phase Ⅱ study of cisplatin with intravenous and oral vinorelbine as induction chemotherapy followed by concomitant chemoradiotherapy with oral vinorelbine and cisplatin for locally advanced non-small cell lung cancer[J].BMC Cancer,2014,14:231.DOI:10.1186/1471-2407-14-231. [4] El-Hadaad HA,Wahba HA,Toson E.Induction chemotherapy followed by weekly paclitaxel and carboplatin with concurrent radiotherapy in inoperable stage Ⅲ non-small cell lung cancers:results of a phase Ⅱ trial[J].Chin Germ J Clin Oncol,2013,12(2):56-60.DOI:10.1007/s10330-012-1087-5. [5] Lichtenstein MJ,Mulrow CD,Elwood PC.Guidelines for reading case-control studies[J].J Chronic Dis,1987,40(9):893-903.DOI:10.1016/0021-9681(87)90190-1. [6] Lee HW,Choi JH,Lim HY,et al. The addition of induction chemotherapy with etoposide,ifosfamide,and cisplatin failed to improve therapeutic outcome of concurrent chemoradiotherapy in patients with locally advanced non-small cell lung cancer-single institution retrospective analysis[J].Neoplasma,2006,53(1):30-36. [7] Vokes EE,Herndon JE Ⅱ,Kelley MJ,et al. Induction chemotherapy followed by chemoradiotherapy compared with chemoradiotherapy alone for regionally advanced unresectable stage Ⅲ non-small-cell lung cancer:cancer and leukemia group B[J].J Clin Oncol,2007,25(13):1698-1704.DOI:10.1200/JCO.2006.07.3569. [8] Huang EH,Liao ZX,Cox JD,et al. Comparison of outcomes for patients with unresectable,locally advanced non-small-cell lung cancer treated with induction chemotherapy followed by concurrent chemoradiation vs.concurrent chemoradiation alone[J].Int J Radiat Oncol Biol Phys,2007,68(3):779-785.DOI:10.1016/j.ijrobp.2007.01.002. [9] 伍楚蓉,杨文,黄红东,等.培美曲塞加顺铂诱导化疗联合同期放化疗对局部晚期非小细胞肺癌的疗效[J].中国老年学杂志,2013,33(19):4739-4742.DOI:10.3969/j.issn.1005-9202.2013.19.037. Wu CR,Yang W,Huang HD,et al. The curative effect of induction chemotherapy with pemetrexed plus cisplatin combine concurrent chemoradiation for locally advanced non-small cell lung cancer[J].Chin J Gerontology,2013,33(19):4739-4742.DOI:10.3969/j.issn.1005-9202.2013.19.037. [10] 韩淑红,张小涛,吴雪松,等.多西他赛加顺铂诱导化疗联合同期放化疗局部晚期非小细胞肺癌的临床观察[J].中华放射肿瘤学杂志,2012,21(1):16-19.DOI:10.3760/cma.j.issn.1004-4221.2012.01.006. Han SH,Zhang XT,Wu XS,et al. Outcomes of docetaxel and cisplatin induction chemotherapy followed by concurrent chemoradiotherapy in locally advanced non-small cell lung cancer[J].Chin J Radiat Oncol,2012,21(1):16-19.DOI:10.3760/cma.j.issn.1004-4221.2012.01.006. [11] 吕纪马,王绿化,周宗玫,等.放射治疗同期紫杉醇化疗局部晚期非小细胞肺癌的Ⅱ期临床研究[J].中华放射肿瘤学杂志,2004,13(2):89-92.DOI:10.3760/j.issn:1004-4221.2004.02.004. Lyu JM,Wang LH,Zhou ZM,et al. Phase Ⅱ study on concomitant paclitaxel and radiotherapy for loc ally advanced non-small cell lung cancer[J].Chin J Radiat Oncol,2004,13(2):89-92.DOI:10.3760/j.issn:1004-4221.2004.02.004. [12] Belani CP,Choy H,Bonomi P,et al. Combined chemoradiotherapy regimens of paclitaxel and carboplatin for locally advanced non-small-cell lung cancer:a randomized phase Ⅱ locally advanced multi-modality protocol[J].J Clin Oncol,2005,23(25):5883-5891.DOI:10.1200/JCO.2005.55.405. [13] 杨玲,李连弟,陈育德,等.中国肺癌死亡趋势分析及发病、死亡的估计与预测[J].中国肺癌杂志,2005,8(4):274-278.DOI:10.3779/j.issn.1009-3419.2005.04.05. Yang L,Li LD,Chen YD,et al. Mortality time trends and the incidence and mortality estimation and projection for lung cancer in China[J].Chin J Lung Cancer,2005,8(4):274-278.DOI:10.3779/j.issn.1009-3419.2005.04.05. [14] Tsujino K,Kurata T,Yamamoto S,et al. Is consolidation chemotherapy after concurrent chemo-radiotherapy beneficial for patients with locally advanced non-small-cell lung cancer? A pooled analysis of the literature[J].J Thorac Oncol,2013,8(9):1181-1189.DOI:10.1097/JTO.0b013e3182988348. [15] Saitoh JI,Saito Y,Kazumoto T,et al. Concurrent chemoradiotherapy followed by consolidation chemotherapy with Bi-weekly docetaxel and carboplatin for stage Ⅲ unresectable,non-small-cell lung cancer:clinical application of a protocol used in a previous phase Ⅱ study[J].Int J Radiat Oncol Bio Phys,2012,82(5):1791-1796.DOI:10.1016/j.ijrobp.2011.03.007. [16] Iranzo V,Bremnes RM,Almendros P,et al. Induction chemotherapy followed by concurrent chemoradiation for patients with non-operable stage Ⅲ non-small-cell lung cancer[J].Lung Cancer,2009,63(1):63-67.DOI:10.1016/j.lungcan.2008.04.016.
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