康莱特联合化疗治疗非小细胞肺癌的系统评价

System Review on Kanglaite Combined with Chemotherapy in Treatment of Non-Small Cell Lung Cancer

目的:该研究旨在评价临床上康莱特联合化疗治疗非小细胞肺癌的疗效和不良反应及生活质量改善情况。方法:利用计算机检索Cochrane Library,Web of Science,PubMed,FMJS,中国生物医学文献数据库,维普知识资源系统,中国期刊全文数据库,万方数据知识服务平台,检索时间从各数据库至截止2012年12月31日,同时辅助其他检索,纳入康莱特联合化疗药物治疗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RevMan5.2软件进行Meta分析。结果:共纳入17篇RCTs,共计病例数为1615例,Meta分析结果显示,与单纯化疗药物相比,康莱特联合化疗药物可以提高临床有效率(OR=1.71,95%CI:1.40~2.10,P<0.00001);改善生活质量(OR=3.17,95%CI:2.42~4.15,P<0.00001);提高免疫力,CD3(MD=9.84,95%CI:9.71~9.97,P<0.00001);CD4(MD=11.16,95%CI:10.97~11.36,P<0.00001);CD8(MD=-0.66,95%CI:-0.99^-0.34,P<0.0001);CD4/CD8(MD=0.48,95%CI:0.46~0.51,P<0.00001),减轻白细胞下降(OR=0.54,95%CI:0.38~0.77,P=0.0007)、降低恶心呕吐等胃肠道反应(OR=0.40,95%CI:0.24~0.67,P=0.0006)。结论:康莱特联合化疗药物可提高非小细胞肺癌治疗的临床有效率,改善骨髓抑制,降低化疗产生的不良反应,提高患者免疫功能并提高患者生活质量,值得临床推广使用。

Objective：To assess the efficacy and adverse effects and to evaluate their quality of life of Kanglaite com- bined with chemotherapy for non - small cell lung cancer （NSCLC）. Method： The relevant randomized controlled trials （RCTs） were searched from Cochrane Library, PubMed, FMJS, CBM, and CNKI, etc. The search was finished in Decem- ber 31,2012. And the related references and expertsin this field was traced. Besides, it was also communicated with other authors in order to obtain some certain information that had not been found. RCTs of Kanglaite combined with chemothera- py for NSCLC were included. The quality of these included studies was evaluated and the data was analyzed by Cochrane Collaboration~ RevMan 5.2. software. Result：Seventeen RCTs were included. The Meta - analysis results suggested that compared with chemotherapy alone, the combination had a statistically significant benefit in healing efficacy （ OR = 1.71, 95 % CI ： 1.40 - 2.10,P 〈 0. 00001 ） and improving quality of life （ OR = 3.17,95 % CI ： 2.42 - 4.15, P 〈 0. 00001 ）. Besides, the combination also had a statistically significant benefit in myelosuppression, white blood cell （ OR = 0.54, 95 % CI ： 0.38 - 0.77, P = 0. 0007 ） , and reducing nausea and vomiting （ OR = 0.40,95 % CI ： 0.24 - 0.67, P = 0. 0006 ） , reducing the of CD3 （ MD =9.84,95% C1：9.71 -9.97 ,P 〈 0. 00001 ） ,CD4 （ MD = 11.16,95% CI： 10.97 - 11.36 ,P 〈0.00001）,CD8 （MD = -0.66,95% CI：-0.99- -0.34,P〈0.0001）,CD4/CD8（MD=0.48,95%CI：0.46- 0. 51, P 〈 0. 00001 ）. Conclusion：Effects of Kanglaite combined with chemotherapy can improve the clinical therapy of non - small cell lung cancer with efficiency, improve the bone marrow suppression, reduce the adverse reaction of chemother- apy in production, improve the immune function of the patients and improve the quality of life of patients. It is worthy ofclinical use.