鸦胆子油乳联合含铂类一线化疗方案治疗非小细胞肺癌的Meta分析

Meta-analysis on treatment of non-small cell lung cancer with brucea javanica oil emulsion in combination with platinum-contained first-line chemotherapy

目的:该研究旨在评价鸦胆子油乳(brucea javanica oil emulsion,BJOE)联合含铂类一线化疗药物治疗非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效和安全性。方法:计算机检索Cochrane Library,PubMed,EMBASE,中国生物医学文献数据库,中国期刊全文数据库,中文科技期刊全文数据库,检索时间截止2011年2月,纳入有关鸦胆子油乳联合含铂类一线化疗药物治疗NSCLC的随机对照试验(randomized controlled trials,RCTs),由2名研究员分别独立提取数据和进行文献质量评价,并用RevMan5.1.2软件进行Meta分析。结果:共纳入22篇RCTs,共计病例数为1 512例。Meta分析结果显示,与单纯运用含铂类一线化疗方案相比,联合鸦胆子油乳能明显增加NSCLC患者化疗效果(RR=1.31,95%CI:1.18～1.45,P<0.000 01),提高生活质量(RR=1.78,95%CI:1.51～2.09,P<0.000 01),增强机体免疫力,降低骨髓抑制(OR=0.37,95%CI:0.27～0.51,P<0.000 01)和消化道毒副反应(OR=0.59,95%CI:0.44～0.80,P=0.000 7)。结论:鸦胆子油乳能提高非小细胞肺癌患者的化疗效果,改善生活质量,并降低含铂类化疗药物的毒副作用,值得临床借鉴。

Objective： To study the efficacy and safety of brucea javanica oil emulsion （BJOE） combining platinum-contained first-line chemotherapy in treating non small cell lung cancer （NSCLC）. Method： Cochrane library, PubMed, EMBASE, VIP, CBM and CNKI were searched through computers. The search was finished in February, 2011. Randomized controlled trials （RCTs） of B JOE combining platinum-contained first-line chemotherapy were included. Two researchers extracted data and assess literature quality sepa- rately,and made a meta-analyses by RevMan 5.1.2 software. Result： Totally 22 RCTs involving 1 512 patients were included. The Meta-analysis showed that compared with the pure application of platinum-contained first-line chemotherapy, the combination of B JOE and chemotherapy can enhance the near-term curative effect （ RR = 1.31,95% CI ： 1.18 - 1.45, P 〈 0. 000 01 ） , improve the quality of life （ RR = 1.78,95 % CI ： 1.51-2. 09, P 〈 0. 000 01 ） and reduce the suppression of bone marrow （ OR = 0. 37,95 % CI：0. 27-0. 51, P 〈 0. 000 01 ） and the gastrointestinal reactions （ OR = 0. 59,95 % CI：0. 44-0. 80, P = 0. 000 7 ）, with an improvement in organism immuni- ty. Conclusion： The current evidence indicates that B JOE can enhance the chemotherapeutic effect on NSCLC patients, improve the quality of life and reduce adverse effect of platinum-contained chemotherapeutics and thus it is worth referring in clinic.