Safety and efficacy of radiotherapy/chemoradiotherapy combined with immune checkpoint inhibitors for non-small cell lung cancer: A systematic review and meta-analysis

作者：Jing Wu, Tingting Ni, Rong Deng, Yan Li, Qin Zhong, Fei Tang, Qi Zhang, Chunju Fang, Yingbo Xue, Yan Zha, Yu Zhang · 发表于：Frontiers in Immunology · 年份：2023 · DOI：10.3389/fimmu.2023.1065510 · 被引用次数：17 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Research Studies、Lung Cancer Diagnosis and Treatment

Background It is now widely accepted that radiotherapy (RT) can provoke a systemic immune response, which gives a strong rationale for the combination of RT and immune checkpoint inhibitors (ICIs). However, RT is a double-edged sword that not only enhances systemic antitumor immune response, but also promotes immunosuppression to some extent. Nevertheless, many aspects regarding the efficacy and safety of this combination therapy remain unknown. Therefore, a systematic review and meta-analysis was performed in order to assess the safety and efficacy of RT/chemoradiotherapy (CRT) and ICI combination therapy for non-small cell lung cancer (NSCLC) patients. Methods PubMed and several other databases were searched (according to specific criteria) to find relevant studies published prior to the 28 th of February 2022. Results 3,652 articles were identified for screening and 25 trials containing 1,645 NSCLC patients were identified. For stage II-III NSCLC, the one- and two-year overall survival (OS) was 83.25% (95% confidence interval (CI): 79.42%-86.75%) and 66.16% (95% CI: 62.3%-69.92%), respectively. For stage IV NSCLC, the one- and two-year OS was 50% and 25%. In our study, the pooled rate of grade 3-5 adverse events (AEs) and grade 5 AEs was 30.18% (95% CI: 10.04%-50.33%, I 2 : 96.7%) and 2.03% (95% CI: 0.03%-4.04%, I 2 : 36.8%), respectively. Fatigue (50.97%), dyspnea (46.06%), dysphagia (10%-82.5%), leucopenia (47.6%), anaemia (5%-47.6%), cough (40.09%), esophagitis (38.51%)...