A meta-analysis for the efficacy and safety of icotinib combined with radiotherapy in treating brain metastases of non-small cell lung cancer

Currently, the therapies for brain metastases of non-small cell lung cancer (NSCLC) mainly include whole brain radiotherapy and icotinib. For exploring the efficacy and safety of radiotherapy and icotinib, a meta-analysis was performed based on a series of data.A systematic search was performed on PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure and Wanfang Database. The search time was set from the database establishment to December, 2022. All randomized controlled trials evaluating the efficacy and safety of whole brain radiotherapy alone or in combination with icotinib for whole brain metastases of NSCLC were included in our meta-analysis. Clinical outcomes and adverse reactions were analyzed using Stata17.0 software.Finally, 10 clinical studies were enrolled in this meta-analysis, including 717 patients. Briefly, compared with radiotherapy alone, icotinib combined with radiotherapy increased response rate [relative ratio (RR) = 1.240; 95% confidence interval (CI) (1.141, 1.348); P < .001] and disease control rate (RR = 1.240, 95% CI [1.141,1.348], P < .001). Besides, according to the outcomes of adverse reaction assessment exhibited, there were no significant differences between the 2 group patients in the incidence of rash (RR = 1.536, 95% CI [0.694, 3.402], P = .290), adverse reaction in gastrointestinal tract (RR = 1.060, 95% CI [0.792, 1.419], P = 1.419), hepatic injury (RR = 1.541, 95% CI [0.798,2.975], P = .198) and leukopenia (RR = 1.182, 95% CI [0.787, 1.777], P = .421). However, the patients receiving combination treatment showed much longer progression free survival than those receiving radiotherapy alone (standardized mean difference = 1.559; 95% CI [0.699, 2.419]; P < .001).Icotinib combined with radiotherapy can significantly short-term and long-term efficacy of NSCLC patients with brain metastases but not increase adverse reactions.