Clinical value of induction chemotherapy plus concurrent radiochemotherapy for locally advanced non-small cell lung cancer: a Meta analysis

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-nd 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-nd 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. (authors)