Clinical outcomes of WBRT plus EGFR-TKIs versus WBRT or TKIs alone for the treatment of cerebral metastatic NSCLC patients: a meta-analysis

Hong Zheng, Quan-Xing Liu, Bin Hou, Dong Zhou, Jing-Meng Li, Xiao Lu, Qiu-Ping Wu and Ji-Gang Dai _

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Oncotarget. 2017; 8:57356-57364. https://doi.org/10.18632/oncotarget.19054

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Hong Zheng1,*, Quan-Xing Liu1,*, Bin Hou1, Dong Zhou1, Jing-Meng Li1, Xiao Lu1, Qiu-Ping Wu1 and Ji-Gang Dai1

1Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China

*These authors contributed equally to this work

Correspondence to:

Ji-Gang Dai, email: [email protected]

Qiu-Ping Wu, email: [email protected]


Received: April 19, 2017     Accepted: June 24, 2017     Published: July 06, 2017


Whether WBRT plus EGFR-TKIs has a greater survival benefit than EGFR-TKIs alone or WBRT alone remains controversial in NSCLC patients with multiple brain metastases. To rectify this, we conducted a systematic meta-analysis based on 9 retrospective studies and 1 randomized controlled study published between 2012 and 2016, comprising 1041 patients. Five studies were included in the comparison of WBRT plus EGFR-TKIs and EGFR-TKIs alone. The combined HR for OS of patients with EGFR mutation was 1.25 [95% CI 0.98–2.15; P = 0.08] and for intracranial PFS was 1.30 [95% CI 1.03–1.65; P = 0.03], which revealed that EGFR-TKIs alone produced a superior intracranial PFS than WBRT plus EGFR-TKIs. Five studies were included in the comparison of WBRT plus EGFR-TKIs and WBRT alone. The combined HR for OS, intracranial PFS and extracranial PFS were 0.52 [95% CI 0.37–0.75; P = 0.0004], 0.36 [95% CI 0.24–0.53; P < 0.001] and 0.52 [95% CI 0.38–0.71; P < 0.001], respectively, which revealed a significant benefit of WBRT plus EGFR-TKIs compared with WBRT alone. The results indicated that EGFR-TKIs alone should be the first option for the treatment of NSCLC patients with multiple BM, especially with EGFR mutation, since it provides similar OS and extracranial PFS but superior intracranial PFS compared with WBRT plus EGFR-TKIs.

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