培美曲塞维持治疗晚期非小细胞肺癌的Meta分析

Pemetexed for maintenance therapy of non-small cell lung cancer:a meta-analysis

目的本研究旨在对培美曲塞维持治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性进行分析。方法计算机检索PubMed、Medline、Embase、维普、中国期刊全文数据库等数据库,收集培美曲塞单药维持治疗对比最佳支持治疗(BSC)Ⅲb及Ⅳ期非小细胞肺癌的随机对照试验,用Cochrane协作网提供的Revman 5软件对数据进行Meta分析。结果共纳入3个随机对照研究(RCT),共1 257例患者。Meta分析结果显示:与对照组相比,培美曲塞维持治疗组能提高患者疾病控制率(DC)(OR=1.95,95%CI:1.52~2.50,P【0.000 01),且纳入研究均显示,培美曲塞维持治疗在无进展生存期(PFS)及总生存期(OS)方面也有积极意义。培美曲塞维持治疗组G3/4级不良反应均少见,其中乏力、恶心呕吐及贫血有统计学差异(P【0.05),而粒细胞减少无统计学差异(P=0.35)。结论培美曲塞维持治疗对比最佳支持治疗晚期NSCLC,可显著提高疾病控制率、延长无进展生存期及总生存期,并且严重不良反应少见。

Objective To observe the efficacy and toxicity of pemetrexed in maintenance therapy of advanced non-small cell lung cancer(NSCLC).Methods Randomized controlled trial(RCT) was selected on pemetrexed versus best supportive care for advanced NSCLC maintenance therapy from PubMed,Medline,Embase,VIP and CNKI.Meta-analysis was completed using software Review Manager 5.Results A total of 3 RCTs involving 1 257 patients were included.The meta-analysis showed that there were positive effects between the pemetrexed group and the best supportive care in the disease control(OR = 1.95,95% CI:1.52 ~ 2.50,P<0.000 01),all studies showed that pemetrexed could significantly lengthen the progression-free survival and overall survival.The major adverse events for pemetrexed were fatigue,nausea and anaemia(P<0.05),while pemetrexed showed lower neutropenia(P = 0.35).Conclusions Pemetrexed versus best supportive care might have more superior efficacy in maintenance therapy of advanced NSCLC,and fewer adverse effects.