Non-platinum doublets versus single agents in non-small cell lung cancer （NSCLC） patients with elderly age and/or poor performance status： a meta-analysis

学习的目的是在以前未经治疗的先进非小的房间肺癌症(NSCLC ) 把非铂马甲(马甲组) 的功效和毒性与一个非铂单身者代理人(单个代理人的组) 作比较的目的有老年龄或差的表演地位(PS ) 的病人。PubMed 数据库被屏蔽的方法。随后，为全面幸存( OS )的危险比率( HR )和没有前进的幸存( PFS )，为全面反应的相对风险( RR )评价( ORR )并且一个年幸存，并且为毒性的不同类型的机会比率( ORs )用评论经理 5.0 包裹被分享。这研究 1427 个病人包括了的结果在四注册了使随机化的控制试用。分享的 HR 证明马甲组能增加 ORR (P = 0.002 ) 没有异质(P = 0.64 ) ，并且可能改进 OS (P = 0.01 / P = 0.06 ) 与异质(P < 0.001 ) 。在 PFS 没有重要差别(P = 0.16 ) 并且一个年幸存(P = 0.25 ) 在二个治疗组之间。马甲组比单个代理人的组导致了更多的等级 3/4 嗜中性白血球减少症和 thrombocytopenia (P = 0.02 并且 P = 0.000，分别地) 。等级 3/4 贫血症的发生，呕吐，在二个治疗组之间的 mucositis，便秘，腹泻， neurotoxicity，过敏症，和疲劳是不足道的。结论除了嗜中性白血球减少症和 thrombocytopenia，非铂马甲能增加 ORR，和力量没有更多的副作用的增加，与老年龄或差的 PS 为 NSCLC 病人改进 OS；然而，马甲显示出嗜中性白血球减少症和 thrombocytopenia 的增加的率。马甲的增加不能改进 PFS 和一个年幸存。

Objective： The aim of the study was to compare the efficacies and toxicities of non-platinum doublets （doublets group） with a non-platinum single agent （single-agent group） in previously untreated advanced non-small cell lung cancer （NSCLC） patients with elderly age and/or poor performance status （PS）. Methods： The PubMed database was screened. Subsequently, the hazard ratios （HRs） for overall survival （OS） and progression-free survival （PFS）, relative risks （RRs） for overall response rate （ORR） and one-year survival, and odds ratios （ORs） for the different types of toxicities were pooled using the Review Manager 5.0 package. Results： This study comprised of 1427 patients enrolled in four randomized controlled trials. The pooled HR showed that the doublet group could increase ORR （P = 0.002） with no heterogeneity （P = 0.64）, and might improve OS （P = 0.01 / P = 0.06） with heterogeneity （P 0.001）. There was no significant difference in PFS （P = 0.16） and one-year survival （P = 0.25） between two treatment groups. The doublet group led to more grade 3/4 neutropenia and thrombocytopenia than the single-agent group （P = 0.02 and P = 0.000, respectively）. The incidences of grade 3/4 anemia, vomiting, mucositis, constipation, diarrhea, neurotoxicity, allergy, and fatigue between the two treatment groups were insignificant. Conclusion： Except for neutropenia and thrombocytopenia, the non-platinum doublets could increase ORR, and might improve OS for NSCLC patients with elderly age and/or poor PS without addition of more side effects; however, the doublets showed an increased rate of neutropenia and thrombocytopenia. The addition of doublets may not improve PFS and one-year survival.