埃克替尼治疗非小细胞肺癌患者EGFR基因突变型与野生型临床疗效的Meta分析

Clinical Efficacy of Icotinib for Non-small Cell Lung Cancer in Patients with Mutant and Wild Type EGFR Gene:A Meta-analysis

目的:系统评价埃克替尼对非小细胞肺癌(NSCLC)患者EGFR基因突变型与野生型的临床疗效,以为临床治疗提供循证参考。方法:计算机检索中国生物医学文献数据库、中国期刊全文数据库、维普中文数据库、Pub Med和Cochrane图书馆临床对照试验资料库,收集埃克替尼治疗NSCLC的相关研究,提取资料并进行质量评价后,采用Rev Man 5.2和SPSS 18.0统计软件对所有数据进行分析。结果:共纳入10项研究,合计262例患者。Meta分析结果显示,埃克替尼治疗NSCLC患者EGFR基因突变型的客观缓解率[OR=6.97,95%CI(3.53,13.78),P<0.000]和疾病控制率[RR=1.51,95%CI(1.13,2.01),P=0.005]优于野生型,差异有统计学意义。结论:埃克替尼治疗NSCLC患者EGFR基因突变型的临床疗效优于野生型,治疗NSCLC时可以检测EGFR基因是否突变,以指导临床治疗。鉴于当前研究数量较少、质量偏低,该结论尚需大样本、高质量的随机对照试验进一步验证。

OBJECTIVE：To evaluate the clinical efficacy of icotinib on non-small cell lung cancer（NSCLC）in patients with mutant and wild type EGFR gene systematically. METHODS：Retrieved from CBM,CNKI,VIP,Pub Med and Cochrane library,trials about icotinib in the treatment of NSCLC in patients with mutant and wild type EGFR gene were collected. Meta-analysis was conducted by using Rev Man 5.2 and SPSS 18.0 statistical software after extracting data. RESULTS：A total of 10 studies were included,involving 262 patients. Meta-analysis showed that objective response rate（ORR） [OR=6.97,95% CI（3.53,13.78）,P〈0.000] and disease control rate（DCR）[RR=1.51,95%CI（1.13,2.01）,P=0.005] of icotinib for NSCLC in patients with mutant type EGFR gene were significantly better than in patients with wild type EGFR gene;there was statistical significance. CONCLUSIONS：The clinical efficacy of icotinib for NSCLC in mutant type EGFR gene patients is better than that for NSCLC of wild-type.Due to small-scale and low quality of included studies,more large-scale and high-quality studies are required for further validation.