紫杉醇联合奥沙利铂对比紫杉醇联合顺铂治疗中晚期非小细胞肺癌疗效和安全性评价的Meta分析被引量：8

Paclitaxel/oxaliplatin versus paclitaxel/cisplatin for advanced non-small cell lung cancer:a Meta analysis of randomized controlled trial

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摘要目的：系统评价紫杉醇（paclitaxel）联合奥沙利铂（oxaliplatin）（PO方案）与紫杉醇联合顺铂（cisplatin）（PC方案）治疗中晚期非小细胞肺癌（non-small cell lung cancer,NSCLC）的安全性和临床疗效。方法：计算机检索Cochrane Library、Pubmed、EMbase、Web of Science、CNKI、CBM-disc、VIP、万方数据等数据库中关于对比PC和PO治疗中晚期NSCLC疗效的随机对照试验（randomized controlled trial,RCT）。截止时间设为2013年10月。由2位研究者独立进行文献筛选、资料提取和方法学质量评价后,采用RevMan 5.0软件进行Meta分析。结果：共纳入14篇RCT（929例患者）。PC方案和PO方案在客观缓解率（RR=1.10,95%CI=0.91~1.32,P=0.33）、疾病控制率（RR=1.02,95%CI=0.93~1.11,P=0.65）、1年生存率（RR=1.03,95%CI=0.81~1.31,P=0.84）和脱发率（RR=0.96,95%CI=0.76~1.22,P=0.75）方面的差异无统计学意义。PC方案在白细胞减少（RR=0.66,95%CI=0.48~0.91）、消化道毒性（RR=0.37,95%CI=0.29~0.48）、肾毒性方面较PO方案明显（RR=0.10,95%CI=0.04~0.23）（P〈0.05）。PO方案在神经毒性方面较PC方案明显（RR=3.73,95%CI=1.99~6.98）（P〈0.05）。结论：PO方案与PC方案治疗中晚期NSCLC的疗效相当,但PO方案的毒副作用相对较低,可考虑作为诊疗指南与规范之外的一种超常规化疗方案。 Objective：To systematically evaluate the efficacy and acceptability of paclitaxel plus cisplatin（PC）and paclitaxel plus oxaliplatin（PO）for treating patients with advanced non-small cell lung cancer. Methods：PubMed,Cochrane Library,Embase,Web of Science,CNKI,CBM-disc,VIP and WanFang Data were searched up to October 2013. Randomized controlled trials（RCTs）of PC versus PO for trearing advanced non-small cell lung cancer were extracted,reviewed,and validated according to the study protocol by two reviewers independently. Results：Fourteen RCTs involving 929 patients were included. The pooled results indicated that PC and PO had comparable efficacy concerning overall response rate（RR=1.10,95%CI=0.91 to 1.32,P=0.33）,disease control rate（RR=1.02,95%CI=0.93 to 1.11,P=0.65）,one-year survival rate（RR=1.03,95%CI=0.81 to 1.31,P=0.84）and alopecia rate（RR=0.96,95%CI=0.76 to 1.22,P=0.75）. Leucopenia,gastrointestinal and kidney toxicity were more serious in PC（P＆lt;0.05）. Neuritis toxicity was more serious in PO（P＆lt;0.05）. Conclusion：PO had the same efficacy as PC in treating mid-advanced non-small cell lung cancer,but its toxic effect is milder,and could be considered as supernormal chemotherapy besides the conventional guideline and norm. Simultaneously,research advances in this field should be continued to make the results more reasonable.

作者王婧雅龙锐王红梅陈虹邱峰

机构地区重庆医科大学附属第一医院药学部重庆医科大学附属第一医院呼吸科

出处《重庆医科大学学报》 CAS CSCD 北大核心 2014年第6期870-877,共8页 Journal of Chongqing Medical University

基金重庆市卫生局医学科研重点资助项目(编号:2011-1-036)

关键词非小细胞肺癌紫杉醇顺铂奥沙利铂 META分析系统评价随机对照试验 non-small cell lung cancer paclitaxel cisplatin oxaliplatin Meta analysis systematic review randomized controlled trial

分类号 R979.1 [医药卫生—药品]

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