Meta-analysis of efficacy and safety of chemoradiotherapy combined with immune checkpoint inhibitors versus chemoradiotherapy alone in the treatment of advanced non-small cell lung cancer
Objective To compare the efficacy and safety of chemoradiotherapy combined with immunodetection inhibitors(ICIs)and chemoradiotherapy alone in the treatment of advanced non-small cell lung cancer(NSCLC),and to provide a suitable treatment plan for advanced NSCLC.Methods Retrieve relevant literature from the establishment of PubMed,Embase,and Cochrane databases to May 27,2023 was retrieved,using the keywords chemotherapy immune checkpoint in-hibitors,carcinoma,non-small-cell lung cancer.Inclusion criteria:Comparing the efficacy and safety of radiotherapy and chemotherapy combined with ICIs and chemoradiotherapy alone;The outcome measures of the study include overall sur-vival(OS),progression free survival(PFS),1-year overall survival,1-year progression free survival,and incidence of ad-verse reactions;Language restrictions on English.Exclusion criteria:Single arm test;Case reports,cadaveric or animal ex-periments,literature reviews,news,comments,letters;Clinical datasets with incomplete information and repeated reports.Results A total of 23 studies were included.In the efficacy analysis,compared with chemoradiotherapy alone,chemoradio-therapy combined with ICIs improved OS(HR=0.57,95％CI:0.52-0.62,P＜0.001),PFS(HR=0.58,95％CI:0.53-0.62,P＜0.001),1-year OS rate(OR=1.98,95％CI:1.68-2.34,P＜0.001)and PFS rate(OR=1.85,95％CI:1.62-2.12,P＜0.001).In the safety analysis,the incidence of adverse events of any grade(OR=1.93,95％CI:1.34-2.78,P＜0.001),pneumonia of any grade(OR=1.64,95％CI:1.24-2.16,P＜0.001),fever of any grade(OR=1.96,95％CI:1.18-3.24,P=0.001),rash(OR=1.10,95％CI:0.73-1.67,P=0.009),pruritus(OR=3.51,95％CI:1.86-6.62,P＜0.001),thyroid dysfunction(OR=8.15,95％CI:3.24-20.48,P＜0.001)were higher in the chemoradiothera-py combined with ICIs group than those in chemoradiotherapy alone.Conclusion For patients with advanced NSCLC,che-moradiotherapy combined with ICIs is more effective than chemoradiotherapy alone,but it increases the incidence of ad-verse events in respiratory,skin and endocrine systems.
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