培美曲塞单药对比多西紫杉醇二线治疗晚期非小细胞肺癌的系统评价

Pemetrexed alone versus docetaxel as second-line treatment for patients with advanced non-small-cell lung cancer: a systematic review

目的:比较培美曲塞单药与多西紫杉醇单药二线治疗晚期非小细胞肺癌的临床疗效和安全性。方法:采用Cochrane系统评价方法进行资料提取、分析、评价,并使用RevMan 5.0软件进行Meta分析。结果:共纳入5个研究,916例晚期非小细胞肺癌(NSCLC)患者。Meta分析结果显示,与对照组多西紫杉醇相比,培美曲塞治疗晚期NSCLC的总反应率、一年生存率、疾病控制率等的差别无统计学意义,可以认为二者疗效相当。不良反应方面,培美曲塞和多西紫杉醇在轻度及重度中性粒细胞减少、重度血小板下降和轻度脱发方面的发生率方面的差异具有统计学意义。其中,在轻度及重度中性粒细胞减少和轻度脱发方面培美曲塞优于多西紫杉醇,而在重度血小板下降方面多西紫杉醇优于培美曲塞。在其他各个方面的不良反应发生率中,两组差异没有统计学意义。结论:培美曲塞单药二线治疗晚期NSCLC的疗效确切。与多西紫杉醇比较,二者疗效差异不明显,不良反应发生率存在一些差异。

Objective：To compare and evaluate the effectiveness and safety of pemetrexed alone versus docetaxel as second-line treatment for patients with advanced non-small-cell lung cancer （ NSCLC ）. Methods ： Search strategy, sample selection, assessment, data collection and analysis were undertaken by two authors according to the Cochrane handbook for systematic reviews, and the Meta-analyses were performed using RevMan 5.0 software. Results：Five RCTs involving 916 patients were included. The results of recta-analyses showed that there were no statistical differences between pemetrexed and docetaxel in the overall response rate, 1-year survival rate and disease control rate. Pemetrexed is superior to docetaxel in the side effects of neutropenia and mild hair loss; docetaxel is superior in the side effect of severe thrombocytopenia; there were no statistical differences between the other adverse reactions concerned in this paper. Conclusion ：The clinical efficiency of pemetrexed and docetaxel as secondline treatment in patients with advanced NSCLC is similar, but the side effects were different.