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Meta-Analysis
. 2013;8(3):e58466.
doi: 10.1371/journal.pone.0058466. Epub 2013 Mar 13.

Chemotherapy plus best supportive care versus best supportive care in patients with non-small cell lung cancer: a meta-analysis of randomized controlled trials

Chenxi Zhong  1 , Hongcheng Liu, Liyan Jiang, Wei Zhang, Feng Yao
Affiliations
Meta-Analysis

Chemotherapy plus best supportive care versus best supportive care in patients with non-small cell lung cancer: a meta-analysis of randomized controlled trials

Chenxi Zhong et al. PLoS One. 2013.

Abstract

Background: The use of chemotherapy has been proposed to increase the effectiveness of best supportive care (BSC) in patients with non-small cell lung cancer (NSCLC). Previous trials reported inconsistent findings regarding the efficacy and safety of chemotherapy on overall survival (OS) and treatment-related mortality. We performed a systematic review and meta-analysis to evaluate the effects of chemotherapy plus BSC versus BSC alone on survival of patients with NSCLC.

Methodology and principal findings: We systematically searched PubMed, EmBase, and the Cochrane Central Register of Controlled Trials for relevant literature. All eligible studies included patients with NSCLC who had received chemotherapy and BSC or BSC alone. All eligible studies measured at least 1 of the following outcomes: OS or treatment-related mortality. Overall, patients that received chemotherapy plus BSC had significant longer OS than those that received BSC alone (HR, 0.76; 95%CI, 0.69-0.84; P<0.001). Additionally, chemotherapy plus BSC as compared to BSC alone resulted in a 28% RR reduction (95%CI: 12-40; P = 0.001) in 6-month mortality, 11% RR reduction (95%CI: 8-15; P<0.001) in 12-month mortality, and 5% RR reduction (95%CI: 1-8; P = 0.02) in 2-year mortality. Toxicity was greater in patients that received chemotherapy plus BSC.

Conclusion/significance: Chemotherapy plus BSC increased the OS and reduced the 6-month, 12-month, and 2-year mortality of NSCLC patients.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Identification process for eligible studies.
Figure 2
Figure 2. Comparison of overall survival between chemotherapy plus best supportive care and best supportive care alone.
Figure 3
Figure 3. Comparison of 6-month mortality (A), 12-month mortality (B), and 2-year mortality (C) between chemotherapy plus best supportive care and best supportive care alone.
Figure 4
Figure 4. Meta-regression of (A) percentage male, (B) mean age, and (C) interventions for overall survival.
See this image and copyright information in PMC

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