Home Medicine Gefitinib versus docetaxel in treated non-small-cell lung cancer: a meta-analysis
Article Open Access

Gefitinib versus docetaxel in treated non-small-cell lung cancer: a meta-analysis

  • Bing Wang , Zhanjie Zuo , Fang Li , Kun Yang , Minjun Du and Yushun Gao EMAIL logo
Published/Copyright: June 14, 2017
Download Article (PDF)
Open Medicine
From the journal Open Medicine Volume 12 Issue 1

Abstract

The objective of this study was to perform a meta-analysis to evaluate the efficacy and toxicity of gefitinib and docetaxel in treated patients with non-small-cell lung cancer (NSCLC). Methods. A literature search was performed using PubMed and CNKI databases for relevant keywords and the Medical Subject Headings. After further full-text screening, 10 clinical trials were included in the final meta-analysis. Specific odds ratios (OR) and confidence intervals were calculated. Results. The outcomes of treatment efficacy included disease control rates, quality-of-life improvement rates, 3~4 grade adverse events. Comparing gefitinib to docetaxel for NSCLC patients, the pooled odds ratios (OR) of disease control rates was 1.09, (95% confidential index [CI] = 0.84–1.43), the pooled OR of quality-of-life improvement rates was 2.49, (95% CI = 1.77–3.49), the pooled OR of 3~4 grade adverse events was 0.49, (95% CI = 0.32–0.75). Conclusion. Gefitinib was found to significantly improve patients’ quality-of-life and obviously decrease patients’ adverse events of 3~4 grade.There is no difference of disease control rates between gefitinib and docetaxel.

Keywords: Docetaxel; Gefitinib; Meta-analysis; NSCLC

1 Introduction

Lung cancer remains the most lethal cancer, which is a serious harm to human health [1].

Non-small-cell lung cancer (NSCLC) accounted for more than 80% of lung cancer, and advanced NSCLC is still an incurable disease [2]. As the standard second-line treatment of NSCLC, docetaxel and ifosfamide, vinorelbine, can significantly prolong the median survival, but their hematologic toxicity was significant [3, 4]. Pemetrexed as a second-line treatment compared with docetaxel, their efficacy is comparable and toxicity of pemetrexed is significantly reduced, but it is still cytotoxic drugs [5].The results of a series of clinical trials showed that the efficiency of chemotherapy was only 20% to 40% for advanced non-small-cell lung cancer and one year survival rate is only 35% to 45% [6, 7]. Gefitinib is an oral targeted molecular that inhibits tumor cell growth by targeting a specific enzyme on the epidermal growth factor receptor [8]. At present, gefitinib has been applied to clinical, but there is still a big controversy. This study aims to perform a meta-analysis to evaluate the clinical efficacy and safety of gefitinib and traditional therapeutic drug docetaxel in the treatment of advanced non-small cell lung cancer.

2 Methods

2.1 Searching method

We searched for relevant studies in PubMed and CNKI databases that were published between 2005 and 2017. The search terms and keywords used included “Docetaxel”, “gefitinib”, “NSCLC” and “non-small-cell lung cancer”. Duplicate articles and unpublished studies from international meetings were excluded.

2.2 Inclusion criteria

Eligible references were selected carefully based on the following criteria: (1) studies comparing the efficacy and toxicity of gefitinib with docetaxel in the treatment of non-small cell lung cancer (NSCLC) randomized controlled trials; (2) patients with non-small-cell lung cancer and liver and kidney function, hematology, ECG no obvious abnormalities; (3) information collected including disease control rates, quality-of-life improvement rates, 3~4 grade adverse events.

2.3 Excluding standard

Non-clinical randomized controlled trials; Non-lung cancer research; To accept other anti-cancer treatment; Data description is not clear; data repeated reports of the larger sample size.

2.4 Data extraction

Two researchers selected independently the relevant literature, and then download and extracted all the data with the use of standardized data-abstraction forms. The study design of the literature according to the above inclusion criteria was included in the evaluation of the patients, the intervention measures and the observation results. The data were extracted from the first author, year of publication, disease control rates, quality-of-life improvement rates, 3~4 grade adverse events.

2.5 Statistical analysis

The summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated by using RevMan (version 5.3). A random-effects (EF) model was adopted. We defined significant heterogeneity as being that of the chi-square test p value <0.1 or an I2 measure >50%, based on a statement from the Cochrane Handbook {Higgins, 2011 #32}.

3 Results

3.1 Literature searches and study characteristics

Figure 1 shows the study selection process. After a preliminary screening of the retrieved literature and further screening, we obtained 10 studies. The basic information for the 10 eligible studies is summarized in Table 1. The funnel plots for each outcome did not show any publication bias (data not shown).

Figure 1 The study selection process
Figure 1

The study selection process

Table 1

Baseline characeristics of included studies

StudyInterventionParticipantsGender(M/F)Age(range)
Cufer, 2006 [15]Gefitinib6847/2134~85
Docetacel7551/2229~83
Li, 2010 [16]Gefitinib5030/2028~79
Docetacel4829/19
Liu, 2012 [17]Gefitinib40Not reported28~79
Docetacel38Not reported
Kim, 2008 [18]Gefitinib733466/26727~84
Docetacel733488/24520~84
Xiong, 2008 [19]Gefitinib26Not reported33~72
Docetacel25Not reported
Zhong, 2009 [20]Gefitinib4421/2332~74
Docetacel3418/1628~78
Lee, 2010 [21]Gefitinib8255/2721~74
Docetacel7945/3420~73
Morere, 2010 [22]Gefitinib4338/545~79
Docetacel4233/930~79
Zhang, 2009 [23]Gefitinib2612/1434~84
Docetacel2820/840~79
Maruyama, 2008 [24]Gefitinib245151/94Not reported
Docetacel244151/93Not reported

3.2 Quality assessment

The Jadad scale, a 5-point scale system, was used to evaluate the methodological quality of trials, which assessed randomization (0–2 points), double-blind (0–2 points), and follow-up (0–1 points) [9]. The Jadal scale has total scores ranged from 0 to 5, and clinical trials are defined as “good” when the score is from 3 to 5. The quality of these enrolled trials was scored according to Jadad’s scale and listed in Table 2.

Table 2

Quality assessment of included studies

StudyPeriodJadad’s quality scores
Cufer, 2006October 2003-June 20043
Li, 2010Not reported3
Liu,2012January 2007 - August 20113
Kim, 2008March 2004 - February 20062
Xiong, 2008May 2004 - February 20062
Zhong, 2009April 2002 - June 20063
Lee, 2010September 2005-September 20062
Morere, 2010December 2004-June 20072
Zhang, 2009October 2006 - December 20071
Maruyama, 2008September 2003-January 20062

3.3 Meta-analysis of the disease control rates of gefitinib and docetaxel

Disease control rates were reported in seven studies (Fig. 2). The pooled OR from these 9 studies was 1.09 (95% CI, 0.84-1.43). The I2 estimate of the variance between the studies is 0% and P = 0.49, which showed low heterogeneity. According to our analysis, the disease control rates between gefitinib and docetaxel was not significant (P = 0.51).

Figure 2 The comparison for the disease control rates between geftinib and docetaxel group
Figure 2

The comparison for the disease control rates between geftinib and docetaxel group

3.4 Meta-analysis of the quality-of-life improvement rates of gefitinib and docetaxel

The quality-of-life improvement rates were reported in five studies (Fig. 3). The pooled OR from these 5 studies was 2.49 (95% CI, 1.77-3.49). The I2 estimate of the variance between the studies is 0% and P = 0.48, which showed low heterogeneity. According to our analysis, the quality-of-life improvement rates between gefitinib and docetaxel was significant (P < 0.01).

Figure 3 The comparison for the quality-of-life improvement rates between geftinib and docetaxel group
Figure 3

The comparison for the quality-of-life improvement rates between geftinib and docetaxel group

Figure 4 The comparison for the 3~4 grade adverse events between geftinib and docetaxel group
Figure 4

The comparison for the 3~4 grade adverse events between geftinib and docetaxel group

3.5 Meta-analysis of the 3~4 grade adverse events of gefitinib and docetaxel

The 3~4 grade adverse events was reported in six studies (Fig. 3). The pooled OR from these 6 studies was 0.49 (95% CI, 0.32-0.75). The I2 estimate of the variance between the studies is 35% and P = 0.17, which showed low heterogeneity. According to our analysis, the 3~4 grade adverse events between gefitinib and docetaxel was significant (P < 0.01).

4 Discussion

As human epithelial cell cancer show that the epidermal growth factor receptor (EGFR) family is aberrantly activated, and high expression of EGFR and poor prognosis of lung cancer is closely related [9]. Therefore, EGFR is an important molecular target. Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) has become a hot topic in recent years. Gefitinib is a molecular targeted drug in the treatment of non-small cell lung cancer. Gefitinib competes with adenosine triphosphate at the ATP binding site in epithelial cells, blocking its tyrosine kinase activity, so EGFR signaling pathway were inhibited, and can induce tumor cell apoptosis [10]. The results of this study indicated that gefitinib had no inferior efficacy to docetaxel with an improvement of disease control rates. In this meta-analysis, we showed that gefitinib significantly improved life quality of patient. Besides, gefitinib decrease 3~4 grade adverse events significantly. Because disease control and quality of life were affected by subjective factors, we were not able to rule out the selection bias. Because of existence of bias, we still need high-quality research to prove its effectiveness. The study also indicated that safety and tolerability of gefitinib is superior to docetaxel group for non-small cell lung cancer. Most of the studies have confirmed that safety and tolerance of gefitinib is better than docetaxel group. In addition, some studies have shown that high expression of EGFR is also considered a sensitive factor to gefitinib [11]. The results of intervention test failed to demonstrate that EGFR over-expression factor was more sensitive to gefitinib, and of course there were some different findings [12, 13]. Studies of EGFR mutations and case characteristics have also been reported in the literature [14], and their relationship with the efficacy of gefitinib remains to be studied further.

In summary, gefitinib has certain advantages for treatment of non-small cell lung cancer. It can be treated as non-small cell lung cancer conventional drugs. However, due to the use of gefitinib by the economic conditions and other effects and the quality of included literature in this study is uneven, we still need high-quality clinical research and economic evaluation support to evaluate clinical application of gefitinib.

  1. Conflict of interest

    Conflict of interest statement: Authors state no conflict of interest

Reference

[1] Esfahani K., Cohen V., HSP90 as a novel molecular target in non-small-cell lung cancer, Lung Cancer (Auckl)., 2016, 7, 11-1710.2147/LCTT.S60344Search in Google Scholar

[2] Singhal S., Vachani A., Antinozerkis D., Kaiser L.R., Albelda S.M., Prognostic implications of cell cycle, apoptosis, and angiogenesis biomarkers in non-small cell lung cancer: a review, Clinical Cancer Research An Official Journal of the American Association for Cancer Research, 2005, 11, 397410.1158/1078-0432.CCR-04-2661Search in Google Scholar

[3] Shepherd F.A., Dancey J., Ramlau R., Mattson K., Gralla R., O’Rourke M., et al., Prospective Randomized Trial of Docetaxel Versus Best Supportive Care in Patients With Non–Small-Cell Lung Cancer Previously Treated With Platinum-Based Chemotherapy, Journal of Clinical Oncology Official Journal of the American Society of Clinical Oncology, 2000, 18, 2095-210310.1200/JCO.2000.18.10.2095Search in Google Scholar

[4] Mani A., Franco S.X., Wang G., Abramson N., Schwartzberg L.S., Jakub J., et al., A phase II tolerability trial of neoadjuvant docetaxel with carboplatin and capecitabine in locally advanced breast cancer, Community Oncology, 2011, 8, 209-21510.1016/S1548-5315(12)70012-8Search in Google Scholar

[5] Hanna N., Shepherd F.A., Fossella F.V., Pereira J.R., De M.F., Von P.J., et al., Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy, Journal of Clinical Oncology Official Journal of the American Society of Clinical Oncology, 2004, 22, 158910.1200/JCO.2004.08.163Search in Google Scholar PubMed

[6] Schiller J.H., Harrington D., Belani C.P., Langer C., Sandler A., Krook J., et al.,, Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer, New England Journal of Medicine, 2002, 346, 92-9810.1056/NEJMoa011954Search in Google Scholar PubMed

[7] Rosell R., Gatzemeier U., Betticher D.C., Keppler U., Macha H.N., Pirker R., et al., Phase III randomised trial comparing paclitaxel/carboplatin with paclitaxel/cisplatin in patients with advanced non-small-cell lung cancer: a cooperative multinational trial, Ann. Oncol., 2002, 13, 1539-154910.1093/annonc/mdf332Search in Google Scholar PubMed

[8] Cohen M.H., Williams G.A., Sridhara R., Chen G., Jr. MGW., Morse D., et al., United States Food and Drug Administration Drug Approval summary: Gefitinib (ZD1839; Iressa) tablets, Clinical Cancer Research An Official Journal of the American Association for Cancer Research, 2004, 10, 1212-12810.1158/1078-0432.CCR-03-0564Search in Google Scholar PubMed

[9] Amann J., Kalyankrishna S., Massion P.P., Ohm J.E., Girard L., Shigematsu H., et al., Aberrant epidermal growth factor receptor signaling and enhanced sensitivity to EGFR inhibitors in lung cancer, Cancer Research, 2005, 65, 226-23510.1158/0008-5472.226.65.1Search in Google Scholar

[10] Dhillon S., Gefitinib: a review of its use in adults with advanced non-small cell lung cancer, Targeted Oncology, 2015, 10, 153-17010.1007/s11523-015-0358-9Search in Google Scholar PubMed

[11] Wu Y.L., Zhong W.Z., Li L.Y., Zhang X.T., Zhang L., Zhou C.C., et al., Epidermal growth factor receptor mutations and their correlation with gefitinib therapy in patients with non-small cell lung cancer: a meta-analysis based on updated individual patient data from six medical centers in mainland China, Journal of Thoracic Oncology, 2007, 2, 430-43910.1097/01.JTO.0000268677.87496.4cSearch in Google Scholar PubMed

[12] Socinski M.A., Update on taxanes in the first-line treatment of advanced non-small-cell lung cancer, Current Oncology, 2014, 21, e691-70310.3747/co.21.1997Search in Google Scholar

[13] Hirsch F.R., Varellagarcia M., Bunn P.A., Franklin W.A., Dziadziuszko R., Thatcher N., et al., Molecular Predictors of Outcome With Gefitinib in a Phase III Placebo-Controlled Study in Advanced Non–Small-Cell Lung Cancer, Journal of Clinical Oncology Official Journal of the American Society of Clinical Oncology, 2006, 24, 503410.1200/JCO.2006.06.3958Search in Google Scholar

[14] Brandes J.C., Amin R., Khuri F., Dong M.S., Prevention of Lung Cancer: Future Perspective with Natural Compounds, Tuberculosis & Respiratory Diseases, 2010, 6, 910.4046/trd.2010.69.1.1Search in Google Scholar

[15] Cufer T., Vrdoljak E., Gaafar R., Erensoy I., Pemberton K., Group S.S., Phase I.I., open-label, randomized study (SIGN) of single-agent gefitinib (IRESSA) or docetaxel as second-line therapy in patients with advanced (stage IIIb or IV) non-small-cell lung cancer, Anti-cancer drugs, 2006, 17, 401-40910.1097/01.cad.0000203381.99490.abSearch in Google Scholar

[16] Li H.M., Wang X.M., Hua F., Clinical study of gefitinib or docetaxel in the treatment of non-small cell lung cancer, zhongguozhongliulinchuang, 2010, 37, 16-18Search in Google Scholar

[17] Liu H.L., Lei H., Deng Q.E., Hou J., Clinical observation of gefitinib and docetaxel in the treatment of advanced non-small cell lung cancer, Zhongwaiyixueyanjiu, 2012, 10, 7-9Search in Google Scholar

[18] Kim E.S., Hirsh V., Mok T., Socinski M.A., Gervais R., Wu Y-L., et al., Gefitinib versus docetaxel in previously treated non-small-cell lung cancer (INTEREST): a randomised phase III trial, The Lancet, 2008, 372, 1809-181810.1016/S0140-6736(08)61758-4Search in Google Scholar

[19] Xiong H.H., Zou Y.M., Xia S., Yu S.Y., Comparison of the efficacy of gefitinib and docetaxel in the treatment of non-small cell lung cancer, Lichuangneikezazhi, 2008, 25, 537-539Search in Google Scholar

[20] Zhong W., Wang M.Z., Zhang L., Zhang X.T., Li L.Y., Treatment of advanced non-small cell lung cancer with gefitinib and docetaxel, Zhongliuxuezazhi, 2009, 15, 508-511Search in Google Scholar

[21] Lee D.H., Park K., Kim J.H., Lee J-S., Shin S.W., Kang J-H., et al., Randomized phase III trial of gefitinib versus docetaxel in non– small cell lung cancer patients who have previously received platinum-based chemotherapy, Clinical cancer research, 2010, 16, 1307-131410.1158/1078-0432.CCR-09-1903Search in Google Scholar PubMed

[22] Morère J-F., Bréchot J-M., Westeel V., Gounant V., Lebeau B., Vaylet F., et al., Randomized phase II trial of gefitinib or gemcitabine or docetaxel chemotherapy in patients with advanced non-small-cell lung cancer and a performance status of 2 or 3 (IFCT-0301 study), Lung Cancer, 2010, 70, 301-30710.1016/j.lungcan.2010.03.003Search in Google Scholar PubMed

[23] Zhang Y., Comparison of Iressa and Docetaxel in the Treatment of Recurrent Non-small Cell Lung Cancer, Shouduyiyao, 2009, 16, 46-47Search in Google Scholar

[24] Maruyama R., Nishiwaki Y., Tamura T., Yamamoto N., Tsuboi M., Nakagawa K., et al., Phase III Study, V-15-32, of Gefitinib Versus Docetaxel in Previously Treated Japanese Patients With Non– Small-Cell Lung Cancer, Journal of Clinical Oncology, 2008, 26, 4244-425210.1200/JCO.2007.15.0185Search in Google Scholar PubMed

Received: 2017-3-11
Accepted: 2017-4-5
Published Online: 2017-6-14

© 2017 Bing Wang et al.

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Articles in the same Issue

  1. Regular Articles
  2. Intravascular treatment of left subclavian artery aneurysm coexisting with aortic coarctation in an adult patient
  3. Regular Articles
  4. Effect of electrical stimulation on blood flow velocity and vessel size
  5. Regular Articles
  6. Live birth pregnancy outcome after first in vitro fertilization treatment in a patient with Systemic Lupus Erythematosus and isolated high positive IgA anti-β2glycoprotein I antibodies: a case report
  7. Regular Articles
  8. Periodontal ligament stem cells regulate apoptosis of neutrophils
  9. Regular Articles
  10. Platelet-rich fibrin (PRF) in implants dentistry in combination with new bone regenerative flapless technique: evolution of the technique and final results
  11. Regular Articles
  12. The significance of strong ion gap for predicting return of spontaneous circulation in patients with cardiopulmonary arrest
  13. Regular Articles
  14. Clinicopathology of EpCAM and EGFR in human epithelial ovarian carcinoma
  15. Regular Articles
  16. Intraosseous lipoma of the mandibula: A case report and review of the literature
  17. Regular Articles
  18. Transurethral resection of the prostate, bladder explosion and hyponatremic encephalopathy: a rare case report of malpractice
  19. Regular Articles
  20. Brain strokes related to aortic aneurysma – the analysis of three cases
  21. Regular Articles
  22. Effect of Bicyclol tablets on drug induced liver injuries after kidney transplantation
  23. Regular Articles
  24. Plasma free fatty acids in hyperemesis gravidarum pregnancy
  25. Regular Articles
  26. Impact of chromosomal rearrangement upon DNA methylation patterns in leukemia
  27. Regular Articles
  28. Gefitinib versus docetaxel in treated non-small-cell lung cancer: a meta-analysis
  29. Regular Articles
  30. The clinical characteristics of patients with chronic idiopathic anal pain
  31. Regular Articles
  32. Bone tunnel impaction reduced the tibial tunnel enlargement
  33. Regular Articles
  34. Effects of S-1 combined with radiotherapy in the treatment of nasopharyngeal cancer: a meta-analysis based on randomized controlled trials
  35. Regular Articles
  36. Predictions and outcomes of atrial fibrillation in the patients with acute myocardial infarction
  37. Regular Articles
  38. An accuracy study of the Intracavitary Electrocardiogram (IC-ECG) guided peripherally inserted central catheter tip placement among neonates
  39. Regular Articles
  40. Serum CA125, CA199 and CEA combined detection for epithelial ovarian cancer diagnosis: A meta-analysis
  41. Regular Articles
  42. Surface coil intensity correction in magnetic resonance imaging in spinal metastases
  43. Regular Articles
  44. Muscle stem cell and physical activity: what point is the debate at?
  45. Regular Articles
  46. MicroRNA let-7g directly targets forkhead box C2 (FOXC2) to modulate bone metastasis in breast cancer
  47. Regular Articles
  48. Monitoring health inequalities at the municipal level: Lithuanian experience
  49. Regular Articles
  50. Role of Epstein-Barr virus in the development of nasopharyngeal carcinoma
  51. Regular Articles
  52. Thrombectomy combined with indwelling-catheter thrombolysis is more effective than pure thrombectomy for the treatment of lower extremity deep venous thrombosis
  53. Regular Articles
  54. Expression of Hepcidin and Neogenin in colorectal cancer
  55. Regular Articles
  56. Carnitine and adiponectin levels in breast cancer after radiotherapy
  57. Regular Articles
  58. Pathophysiology of meningioma growth in pregnancy
  59. Regular Articles
  60. Causal neuro-immune relationships at patients with chronic pyelonephritis and cholecystitis. Correlations between parameters EEG, HRV and white blood cell count
  61. Regular Articles
  62. Measuring efficiency of secondary healthcare providers in Slovenia
  63. Regular Articles
  64. Galectin-3 expression in colorectal cancer and its correlation with clinical pathological characteristics and prognosis
  65. Regular Articles
  66. Model for studying anti- allergic drugs for allergic conjunctivitis in animals
  67. Regular Articles
  68. Barriers perceived by nurses in the optimal treatment of postoperative pain
  69. Regular Articles
  70. Tumor microenvironment in treatment of glioma
  71. Regular Articles
  72. Delirium risk of dexmedetomidine and midazolam in patients treated with postoperative mechanical ventilation: A meta-analysis
  73. Regular Articles
  74. Hemangioma of the rib: a rare case report and literature review
  75. Regular Articles
  76. The diagnostic accuracy of conventional forceps biopsy compared to ESD
  77. Regular Articles
  78. Increased miR-25 expression in serum of gastric cancer patients is correlated with CA19-9 and acts as a potential diagnostic biomarker
  79. Regular Articles
  80. Therapeutic nanomedicine surmounts the limitations of pharmacotherapy
  81. Regular Articles
  82. Relationship between PD-L1 expression and clinical characteristics in patients with breast invasive ductal carcinoma
  83. Regular Articles
  84. Trypsinogen activation peptide induces HMGB1 release from rat pancreatic acinar cells
  85. Regular Articles
  86. The effective regulation of pro- and anti-inflammatory cytokines induced by combination of PA-MSHA and BPIFB1 in initiation of innate immune responses
  87. Regular Articles
  88. Cell based therapeutic approach in vascular surgery: application and review
  89. Regular Articles
  90. Clinical efficacy of alprostadil combined with α-lipoic acid in the treatment of elderly patients with diabetic nephropathy
  91. Regular Articles
  92. Professional burnout and concurrent health complaints in neonatal nursing
  93. Regular Articles
  94. Esophageal xanthoma: presence of M2 macrophages suggests association with late inflammatory and reparative processes
  95. Regular Articles
  96. Cone beam computed tomography analysis in 3D position of maxillary denture
  97. Regular Articles
  98. CK20 mRNA expression in serum as a biomarker for colorectal cancer diagnosis: A meta-analysis
  99. Regular Articles
  100. Serum AFU, 5’-NT and AFP as biomarkers for primary hepatocellular carcinoma diagnosis
  101. Regular Articles
  102. Absolute reliability and concurrent validity of hand held dynamometry and isokinetic dynamometry in the hip, knee and ankle joint: systematic review and meta-analysis
  103. Regular Articles
  104. The Fountain of Youth: A tale of parabiosis, stem cells, and rejuvenation
  105. Regular Articles
  106. Foam sclerotherapy during shunt surgery for portal hypertension and varices
  107. Regular Articles
  108. Insomnia and depression: Japanese hospital workers questionnaire survey
  109. Regular Articles
  110. Serum NF-κBp65, TLR4 as biomarker for diagnosis of preeclampsia
  111. Regular Articles
  112. Docetaxel/cisplatin therapy in myasthenia gravis with hypertension/diabetes
  113. Regular Articles
  114. Fluid resuscitation and markers of glycocalyx degradation in severe sepsis
  115. Regular Articles
  116. Modified Sauve-Kapandji procedure for patients with old fractures of the distal radius
  117. Regular Articles
  118. Bile leakage after liver transplantation
  119. Regular Articles
  120. VEGF overexpression predicts poor survival in hepatocellular carcinoma
  121. Regular Articles
  122. Galen vein aneurysm– challenge for treatment
  123. Regular Articles
  124. Retrieval of a broken sewing needle from the sacrum aided by a permanent magnet: a case report and literature review
  125. Regular Articles
  126. HIV/STI prevention interventions: A systematic review and meta-analysis
  127. Regular Articles
  128. Aortic aneurysm as a complication of myeloperoxidase-antineutrophil cytoplasmic antibody-associated vasculitis
  129. Regular Articles
  130. Real-time monitoring of contrast-enhanced ultrasound for radio frequency ablation
  131. Regular Articles
  132. Successful drug-eluting stent implantation in a male patient with dextrocardia: a case report
  133. Regular Articles
  134. Primary pleomorphic liposarcoma of fallopian tube with recurrence: a case report and review of the literature
  135. Regular Articles
  136. Color Doppler Ultrasound in Uterine Arterial Embolization
  137. Regular Articles
  138. Pattern of alcohol consumption by young people from North Eastern Portugal
  139. Regular Articles
  140. Effects of out-of-hospital continuing nursing on schizophrenia patients' rehabilitation and quality of life
https://doi.org/10.1515/med-2017-0013
Keywords for this article
Docetaxel; Gefitinib; Meta-analysis; NSCLC
Creative Commons
BY-NC-ND 3.0

Articles in the same Issue

  1. Regular Articles
  2. Intravascular treatment of left subclavian artery aneurysm coexisting with aortic coarctation in an adult patient
  3. Regular Articles
  4. Effect of electrical stimulation on blood flow velocity and vessel size
  5. Regular Articles
  6. Live birth pregnancy outcome after first in vitro fertilization treatment in a patient with Systemic Lupus Erythematosus and isolated high positive IgA anti-β2glycoprotein I antibodies: a case report
  7. Regular Articles
  8. Periodontal ligament stem cells regulate apoptosis of neutrophils
  9. Regular Articles
  10. Platelet-rich fibrin (PRF) in implants dentistry in combination with new bone regenerative flapless technique: evolution of the technique and final results
  11. Regular Articles
  12. The significance of strong ion gap for predicting return of spontaneous circulation in patients with cardiopulmonary arrest
  13. Regular Articles
  14. Clinicopathology of EpCAM and EGFR in human epithelial ovarian carcinoma
  15. Regular Articles
  16. Intraosseous lipoma of the mandibula: A case report and review of the literature
  17. Regular Articles
  18. Transurethral resection of the prostate, bladder explosion and hyponatremic encephalopathy: a rare case report of malpractice
  19. Regular Articles
  20. Brain strokes related to aortic aneurysma – the analysis of three cases
  21. Regular Articles
  22. Effect of Bicyclol tablets on drug induced liver injuries after kidney transplantation
  23. Regular Articles
  24. Plasma free fatty acids in hyperemesis gravidarum pregnancy
  25. Regular Articles
  26. Impact of chromosomal rearrangement upon DNA methylation patterns in leukemia
  27. Regular Articles
  28. Gefitinib versus docetaxel in treated non-small-cell lung cancer: a meta-analysis
  29. Regular Articles
  30. The clinical characteristics of patients with chronic idiopathic anal pain
  31. Regular Articles
  32. Bone tunnel impaction reduced the tibial tunnel enlargement
  33. Regular Articles
  34. Effects of S-1 combined with radiotherapy in the treatment of nasopharyngeal cancer: a meta-analysis based on randomized controlled trials
  35. Regular Articles
  36. Predictions and outcomes of atrial fibrillation in the patients with acute myocardial infarction
  37. Regular Articles
  38. An accuracy study of the Intracavitary Electrocardiogram (IC-ECG) guided peripherally inserted central catheter tip placement among neonates
  39. Regular Articles
  40. Serum CA125, CA199 and CEA combined detection for epithelial ovarian cancer diagnosis: A meta-analysis
  41. Regular Articles
  42. Surface coil intensity correction in magnetic resonance imaging in spinal metastases
  43. Regular Articles
  44. Muscle stem cell and physical activity: what point is the debate at?
  45. Regular Articles
  46. MicroRNA let-7g directly targets forkhead box C2 (FOXC2) to modulate bone metastasis in breast cancer
  47. Regular Articles
  48. Monitoring health inequalities at the municipal level: Lithuanian experience
  49. Regular Articles
  50. Role of Epstein-Barr virus in the development of nasopharyngeal carcinoma
  51. Regular Articles
  52. Thrombectomy combined with indwelling-catheter thrombolysis is more effective than pure thrombectomy for the treatment of lower extremity deep venous thrombosis
  53. Regular Articles
  54. Expression of Hepcidin and Neogenin in colorectal cancer
  55. Regular Articles
  56. Carnitine and adiponectin levels in breast cancer after radiotherapy
  57. Regular Articles
  58. Pathophysiology of meningioma growth in pregnancy
  59. Regular Articles
  60. Causal neuro-immune relationships at patients with chronic pyelonephritis and cholecystitis. Correlations between parameters EEG, HRV and white blood cell count
  61. Regular Articles
  62. Measuring efficiency of secondary healthcare providers in Slovenia
  63. Regular Articles
  64. Galectin-3 expression in colorectal cancer and its correlation with clinical pathological characteristics and prognosis
  65. Regular Articles
  66. Model for studying anti- allergic drugs for allergic conjunctivitis in animals
  67. Regular Articles
  68. Barriers perceived by nurses in the optimal treatment of postoperative pain
  69. Regular Articles
  70. Tumor microenvironment in treatment of glioma
  71. Regular Articles
  72. Delirium risk of dexmedetomidine and midazolam in patients treated with postoperative mechanical ventilation: A meta-analysis
  73. Regular Articles
  74. Hemangioma of the rib: a rare case report and literature review
  75. Regular Articles
  76. The diagnostic accuracy of conventional forceps biopsy compared to ESD
  77. Regular Articles
  78. Increased miR-25 expression in serum of gastric cancer patients is correlated with CA19-9 and acts as a potential diagnostic biomarker
  79. Regular Articles
  80. Therapeutic nanomedicine surmounts the limitations of pharmacotherapy
  81. Regular Articles
  82. Relationship between PD-L1 expression and clinical characteristics in patients with breast invasive ductal carcinoma
  83. Regular Articles
  84. Trypsinogen activation peptide induces HMGB1 release from rat pancreatic acinar cells
  85. Regular Articles
  86. The effective regulation of pro- and anti-inflammatory cytokines induced by combination of PA-MSHA and BPIFB1 in initiation of innate immune responses
  87. Regular Articles
  88. Cell based therapeutic approach in vascular surgery: application and review
  89. Regular Articles
  90. Clinical efficacy of alprostadil combined with α-lipoic acid in the treatment of elderly patients with diabetic nephropathy
  91. Regular Articles
  92. Professional burnout and concurrent health complaints in neonatal nursing
  93. Regular Articles
  94. Esophageal xanthoma: presence of M2 macrophages suggests association with late inflammatory and reparative processes
  95. Regular Articles
  96. Cone beam computed tomography analysis in 3D position of maxillary denture
  97. Regular Articles
  98. CK20 mRNA expression in serum as a biomarker for colorectal cancer diagnosis: A meta-analysis
  99. Regular Articles
  100. Serum AFU, 5’-NT and AFP as biomarkers for primary hepatocellular carcinoma diagnosis
  101. Regular Articles
  102. Absolute reliability and concurrent validity of hand held dynamometry and isokinetic dynamometry in the hip, knee and ankle joint: systematic review and meta-analysis
  103. Regular Articles
  104. The Fountain of Youth: A tale of parabiosis, stem cells, and rejuvenation
  105. Regular Articles
  106. Foam sclerotherapy during shunt surgery for portal hypertension and varices
  107. Regular Articles
  108. Insomnia and depression: Japanese hospital workers questionnaire survey
  109. Regular Articles
  110. Serum NF-κBp65, TLR4 as biomarker for diagnosis of preeclampsia
  111. Regular Articles
  112. Docetaxel/cisplatin therapy in myasthenia gravis with hypertension/diabetes
  113. Regular Articles
  114. Fluid resuscitation and markers of glycocalyx degradation in severe sepsis
  115. Regular Articles
  116. Modified Sauve-Kapandji procedure for patients with old fractures of the distal radius
  117. Regular Articles
  118. Bile leakage after liver transplantation
  119. Regular Articles
  120. VEGF overexpression predicts poor survival in hepatocellular carcinoma
  121. Regular Articles
  122. Galen vein aneurysm– challenge for treatment
  123. Regular Articles
  124. Retrieval of a broken sewing needle from the sacrum aided by a permanent magnet: a case report and literature review
  125. Regular Articles
  126. HIV/STI prevention interventions: A systematic review and meta-analysis
  127. Regular Articles
  128. Aortic aneurysm as a complication of myeloperoxidase-antineutrophil cytoplasmic antibody-associated vasculitis
  129. Regular Articles
  130. Real-time monitoring of contrast-enhanced ultrasound for radio frequency ablation
  131. Regular Articles
  132. Successful drug-eluting stent implantation in a male patient with dextrocardia: a case report
  133. Regular Articles
  134. Primary pleomorphic liposarcoma of fallopian tube with recurrence: a case report and review of the literature
  135. Regular Articles
  136. Color Doppler Ultrasound in Uterine Arterial Embolization
  137. Regular Articles
  138. Pattern of alcohol consumption by young people from North Eastern Portugal
  139. Regular Articles
  140. Effects of out-of-hospital continuing nursing on schizophrenia patients' rehabilitation and quality of life
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2026 De Gruyter Brill
Downloaded on 25.1.2026 from https://www.degruyterbrill.com/document/doi/10.1515/med-2017-0013/html
Scroll to top button