卡铂与顺铂治疗晚期非小细胞肺癌疗效的荟萃分析

A meta-analysis of the curative effects of carboplastin-based and cisplatin-based chemotherapeutic regimens on advance non-small cell lung cancer

目的评价以卡铂或以顺铂为基础的两类联合化疔方案治疗晚期非小细胞肺癌的疗效差异。方法在 CENTRAL、PubMed 和中国生物医学文献数据库中检索1995—2005年间比较以卡铂为基础与以顺铂为基础的联合化疗方案治疗晚期非小细胞肺癌的随机对照临床试验。然后对这些文献进行入选标准和质量的评价,并对符合标准的文献进行荟萃分析。结果 18篇文献(包括6478例患者)符合人选标准,总缓解率两组均为27％,RR 为0.93(95％CI,0.86～1.01;P=0.10);一年生存率卡铂组为36％,顺铂组为35％,RR为1.04(95％ CI,0.93～1.17;P=0.5);两个疗效指标差异均无统计学意义。结论以卡铂为基础和以顺铂为基础的联合化疗方案治疗晚期非小细胞肺癌疗效相似。

Objective To evaluate whether there is a difference in the curative effect of carboplastin-based and cisplatin-based chemotherapeutic regimens on advance non-small cell lung cancer （NSCLC）. Methods The databases PudMed, CENTRAL, and Chinese biomedical database were retrieved by using the key words ＂non-small cell lung cancer ＂ or ＂carcinoma, non-small cell lung＂ so as to search the materials about the randomized controlled clinical trials that had compared the curative effects of carboplastin-based and cisplatin-based chemotherapeutic regimens on advance NSCLC. A meta-analysis was conducted. Results Eighteen documents about randomized controlled clinical trials, including 6478 patients, from the retrieved 3531 documents accorded to the demand of enrollment. The overall response rates of the carboplatin-based and cisplatin-based chemotherapeutic groups were both 27% （ RR = 0.93, 95% CI =0.86 -1.01, P = 0.10）. Neither funnel plot nor rank correlation test regarding response rate indicated the existence of publication bias （ x^2 = 18.63, P = 0.63 ）. The 0ne-year survival rate of the carboplastin-based regimen group was 36%, not significantly different from that of the cisplatin-based regimen group （35%, RR = 1.04, 95% CI =0.93-1.17, P = 0.5 ）. Sensitive analysis confirmed the nonexistence of differences in the overall response rate and one-year survival rate between these 2 groups. Conclusion The curative effects of the carboplastin-based and cisplatin-based chemotherapeutic regimens are similar. The choice of carboplatin or cisplatin depends on the toxicity of the drugs and the patients＇ tolerance.