Yi Liu1, Chong Zhao2, Qiuliang Lu1, Yirong Hu3. 1. Department of Thoracic Surgery, The People's Hospital of Yichun City, Jiangxi, 336028, China. 2. Department of Respiratory, The People's Hospital of Yichun City, Jiangxi, 336028, China. 3. Department of Neurology, The People's Hospital of Yichun City, Jiangxi, 336028, China.
Abstract
OBJECTIVE: To compare the efficacy and complications of different neoadjuvant to determine the optimal regimens for nonsmall cell lung cancer (NSCLC) patients. METHODS: A systematic search of the Web of Science, and PubMed databases was conducted through June 3, 2021, reporting a comparison of chemotherapy, chemoradiotherapy, and immunotherapy. RESULTS: Of 3462 studies, 25 were considered for evidence synthesis. 1035 patients who received chemotherapy or radiotherapy before surgery did not prolong the overall survival (OS) compared with 1038 patients who received surgery alone (hazard ratio [HR] 1.13, 95% CI 1·00-1·28, P = 0·05). 1192 patients received chemoradiotherapy and 864 patients received chemotherapy or radiotherapy; chemoradiotherapy prolonged the OS compared with chemotherapy (HR 0.52, 95% CI 0·29 to 0.95, P = .03). Compared with 110 patients who received other therapy, 93 patients who received immunotherapy had prolonged the OS (HR 1.56, 95% CI 1·08-2·25, P = .02). Chemoradiotherapy increased the pathological response rate (HR 1.68, 95% CI 1·33-2·12, P < .0001), and grade 3 and 4 adverse effects were not increased (HR 5.90, 95% CI 0.88 to 39.60, P = .007). Immunotherapy increased the pathological response (HR 2.79, 95% CI 1·71-4·54, P < .0001), with no significant effects on grades 3 and 4 adverse(HR 0.71, 95% CI 0·19-2·64, P = .61). CONCLUSION: Our data showed that chemotherapy may prolong OS and PFS, but not statistically significant; however, the combination of chemotherapy and radiation did show an advantage, and immunotherapy may be also the choice for neoadjuvant therapy.
OBJECTIVE: To compare the efficacy and complications of different neoadjuvant to determine the optimal regimens for nonsmall cell lung cancer (NSCLC) patients. METHODS: A systematic search of the Web of Science, and PubMed databases was conducted through June 3, 2021, reporting a comparison of chemotherapy, chemoradiotherapy, and immunotherapy. RESULTS: Of 3462 studies, 25 were considered for evidence synthesis. 1035 patients who received chemotherapy or radiotherapy before surgery did not prolong the overall survival (OS) compared with 1038 patients who received surgery alone (hazard ratio [HR] 1.13, 95% CI 1·00-1·28, P = 0·05). 1192 patients received chemoradiotherapy and 864 patients received chemotherapy or radiotherapy; chemoradiotherapy prolonged the OS compared with chemotherapy (HR 0.52, 95% CI 0·29 to 0.95, P = .03). Compared with 110 patients who received other therapy, 93 patients who received immunotherapy had prolonged the OS (HR 1.56, 95% CI 1·08-2·25, P = .02). Chemoradiotherapy increased the pathological response rate (HR 1.68, 95% CI 1·33-2·12, P < .0001), and grade 3 and 4 adverse effects were not increased (HR 5.90, 95% CI 0.88 to 39.60, P = .007). Immunotherapy increased the pathological response (HR 2.79, 95% CI 1·71-4·54, P < .0001), with no significant effects on grades 3 and 4 adverse(HR 0.71, 95% CI 0·19-2·64, P = .61). CONCLUSION: Our data showed that chemotherapy may prolong OS and PFS, but not statistically significant; however, the combination of chemotherapy and radiation did show an advantage, and immunotherapy may be also the choice for neoadjuvant therapy.
Authors: Giorgio V Scagliotti; Ugo Pastorino; Johan F Vansteenkiste; Lorenzo Spaggiari; Francesco Facciolo; Tadeusz M Orlowski; Luigi Maiorino; Martin Hetzel; Monika Leschinger; Carla Visseren-Grul; Valter Torri Journal: J Clin Oncol Date: 2011-11-28 Impact factor: 44.544
Authors: Katherine M W Pisters; Eric Vallières; John J Crowley; Wilbur A Franklin; Paul A Bunn; Robert J Ginsberg; Joe B Putnam; Kari Chansky; David Gandara Journal: J Clin Oncol Date: 2010-03-15 Impact factor: 44.544
Authors: R Rosell; J Gómez-Codina; C Camps; J Maestre; J Padille; A Cantó; J L Mate; S Li; J Roig; A Olazábal Journal: N Engl J Med Date: 1994-01-20 Impact factor: 91.245
Authors: Raimundo de A M Neto; Cleydson B R Santos; Shayanne V C Henriques; Letícia de O Machado; Jorddy N Cruz; Carlos H T de P da Silva; Leonardo B Federico; Edivaldo H C de Oliveira; Michel P C de Souza; Patrícia N B da Silva; Carlton A Taft; Irlon M Ferreira; Madson R F Gomes Journal: J Biomol Struct Dyn Date: 2020-11-04
Authors: David Gilligan; Marianne Nicolson; Ian Smith; Harry Groen; Otilia Dalesio; Peter Goldstraw; Matthew Hatton; Penelope Hopwood; Christian Manegold; Franz Schramel; Hans Smit; Jan van Meerbeeck; Matthew Nankivell; Mahesh Parmar; Cheryl Pugh; Richard Stephens Journal: Lancet Date: 2007-06-09 Impact factor: 79.321