Efficacy and safety of radiotherapy combined with zoledronic acid in the treatment of lung cancer with bone metastasis: a meta-analysis

摘要

Highlights Zoledronic acid is the only bisphosphonate that is effective for all bone metastases. The combination of zoledronic acid with radiotherapy may improve the curative effect of lung cancer patients with bone metastasis. Traditional Chinese medicine plays an essential role in the treatment of cancer and now it has been treated as an adjuvant therapy. Western medicine has limited treatment for tumors that have distant metastasis. Traditional Chinese medicine adjuvant therapy may be a new way to treat advanced tumors. Abstract Objective: To evaluate the efficacy and safety of radiotherapy combined with zoledronic acid for the treatment of bone metastases. Methods: Use Pubmed, Cochrane Library, Embase, CBM, CNKI, Wanfang, Weipu tools to search-related databases at home and abroad. From 2013.1 to March 2019, radiotherapy combined with zoledronic acid and radiotherapy alone for bone metastasis of lung cancer were collected. Experimental studies; quality evaluation and data extraction for each of the included studies, and Cochrane risk bias assessment tools for quality evaluation of the literature. Data processing was performed using RevMan 5.3 and Stata 15.0 software, including risk ratio (OR), 95% CI, I 2 , and P values. Line sensitivity test, publication bias evaluation is using Egger's, Bgge's method quantitative calculation using Revman 5.3 and Stata 15.0 software for statistical analysis. Results: The total of 8 articles was included, and the number of cases was 703. The results of the meta-analysis showed that the radiotherapy, combined with the zoledronic acid group was effective in the treatment of lung cancer with bone metastasis. The meta-analysis was Z = 6.31 ( P 0.00001), OR (95% CI = 3.57, (2.41, 5.30)), the difference was statistically significant. The combined effect of bone metastases was better than that of the single-stage group. The meta-analysis results were Z = 3.18 ( P = 0.001) and OR (95% CI = 3.21, (1.57, 6.59)), indicating the therapeutic effect of the two groups in the treatment of bone metastases. The difference is statistically significant. Adverse reactions include: (1) bone marrow suppression, blood toxicity; (2) fever and rash; (3) nausea, vomiting, and fatigue; (4) liver damage and loss of appetite, meta-analysis results are: bone marrow suppression, blood toxicity: Z = 0.73 ( P = 0.47), OR (95% CI = 0.58 (0.13, 2.54)); fever, rash: Z = 0.36 ( P = 0.36), OR (95% CI = 1.3 (0.31, 5.38)); nausea, vomiting, Weakness: Z = 0.29 ( P = 0.77), OR (95% CI = 0.85 (0.27, 2.62)); liver function damage and loss of appetite: Z = 0.00 ( P = 1.00), OR (95% CI = 1.00 (0.17, 6.00)). The P values of the four meta-analyses were all greater than 0.05, and the difference was not statistically significant, indicating that the addition of zoledronic acid to the bone metastasis of lung cancer did not aggravate the changes of the above four adverse reactions. Conclusion: Radiotherapy combined with the zoledronic acid group is better than the single radiotherapy group in treating pain caused by bone metastasis. It can effectively treat bone metastasis and will not aggravate the occurrence of adverse reactions.