GP方案与NP方案治疗晚期非小细胞肺癌的Meta分析

Meta-analysis of GP and NP regimen in advanced non-small cell lung cancer

目的比较临床治疗非小细胞肺癌最常用的一线化疗方案的临床选择对患者的获益性，系统评价GP（吉西他滨联合顺铂）方案与NP方案（长春瑞滨联合顺铂）治疗晚期非小细胞肺癌的近期临床疗效、短期生存率与输注化疗后的急性毒副反应。方法计算机检索PubMed、CENTRAL、EMbase、TheISIWebofKnowledgedatabases、VIP、CNKI、CBM和万方数据库，查找所有比较GP方案与NP方案化疗治疗晚期非小细胞肺癌疗效的随机临床对照实验（RCT），检索时限为2004年1月～2011年12月。依据CochraneHandbook5．0．1的质量评价标准独立进行RCT筛选、资料提取和质量评价后，按Cochrane协作网推荐的方法使用RevMan5．0软件对相关病例对照研究进行Meta分析研究。结果共纳入合格文献7项研究，共517例晚期非小细胞肺癌患者。Meta分析结果显示：GP方案相比于NP方案在治疗有效率、1年生存率、恶心呕吐反应发生率等方面差异无统计学意义（P〉0．05），初次选择GP方案的患者在发生Ⅲ度以上骨髓抑制的发生率方面明显高于NP组，一般进行预防性处理以后，患者大都可以耐受。结论GP方案与NP方案治疗晚期非小细胞肺癌疗效确切一致，且不良反应均可耐受,临床治疗时可根据患者的具体情况选择治疗方案。

Objective To systematically evaluate the curative effect of gemcitabine plus cisplatin and vinorelbine plus cisplatin for the the threatment of advanced NSCLC. Methods The databases such as PubMed, CENTRAL, EMbase, VIP, CNKI, CBM and Wanfang Data were searched to collect all randomized control trials （RCTs） about the the cura- tive effect of gemcitabine plus cisplatin and vinorelbine plus cisplatin for the treatment of advanced NSCLC. The time limit was from January 2004 to December 2011. Literatures were screened according to the inclusive and exclusive criteria by two people independently, the data were extracted, the methodological quality of the included studies was assessed in line with Cochrane Handbook 5.0.1. Meta-analysis was conducted with RevMan 5 software using the meth- ods recommended by the Cochrane Collaboration. Results Seven RCTs involving 517 advanced NSCLC patients were included. Meta analysis results show that： NACT compared to ACT in the response rate, 1 year survival rate, nausea and vomiting frequency, having no statistically significant differences, grade Ⅲ-ⅣV thrombocytopenia rate in GP group was significantly higher than the NP group. Conclusion Both GP and NP regimens are effective for NSCLC and have no significant difference, the side effects of the two regimens are different but all adverse reaction are tolerable. We can chose different treatment methods according to the specific conditions of patients.