艾迪注射液联合放疗治疗非小细胞肺癌的Meta分析

Meta-analysis on Treatment of Non-small Cell Lung Cancer with Aidi Injection in Combination with Radiothreapy

目的:系统评价艾迪注射液联合放疗治疗非小细胞肺癌的疗效及安全性。方法:计算机检索Cochrane Library,美国国立医学图书馆(Pub Med),中国生物医学文献数据库(CBM),中国期刊全文数据库(CNKI),维普中文科技期刊数据库(VIP),万方数据库等数据库,检索时间为各库建库时间至2014年5月。搜索艾迪注射液联合放疗对比单纯放疗治疗非小细胞肺癌的临床随机对照试验,文种不限。由两名评价员独立评价并交叉核对纳入研究质量后,采用Rev Man 5.2软件进行Meta分析。结果:共纳入10个随机对照试验(RCTs),合计共有678例患者,Meta分析结果显示:与单纯放疗相比,艾迪注射液联合放疗治疗非小细胞肺癌能显著提高近期疗效[OR=4.00,95%CI(2.86,5.60),P<0.000 01],并能改善患者的生活质量[OR=4.99,95%CI(3.02,8.26),P<0.000 01],减少放射性肺炎的发生率[RR=0.46,95%CI(0.34,0.63),P<0.000 01],降低放射性食管炎的发生率[RR=0.49,95%CI(0.37,0.66),P<0.000 01],减少骨髓抑制的发生率[RR=0.51,95%CI(0.38,0.69),P<0.000 01]。结论:艾迪注射液联合放疗治疗非小细胞肺癌不但可以增加放疗的近期疗效,而且可以改善患者的生活质量,并能减少放射性肺炎、放射性食管炎和骨髓抑制的发生。然而由于纳入的RCT质量较低,需更多设计合理的高质量临床试验加以验证。

Objective： The aim of this article was to study the efficacy and safety of Aidi injection in combination with radiotherapy in treating non-small cell lung cancer （NSCLC）. Method： Cochrane Library, PubMed, CBM, CNKI, VIP and WANFANG DATA were screened. The retrieval time was from the establishment time of each database to May 2014. Randomized controlled trials （RCTs） of Aidi injection in combination with radiotherapy in any language were included. Two researchers extracted data and assessed the literature quality separatedly, and made a Meta-analysis by RevMan 5.2 software. Result： 10 RCTs involving 678 patients entered the inclusion criteria. The meta-analysis showed that compared with pure application of radiotherapy, Aidi injection in combination with radiotherapy can enhance the short-term curative effect [ OR = 4.00, 95% CI （2.86, 5.60） , P〈0.00001], and improve the quality of life [OR=4.99, 95%CI （3.02, 8.26）, P〈0.00001], decrease the incidence of radiation pneumonitis [ RR = 0.46, 95% CI （0.34, 0.63）, P 〈 0. 000 01 ] radiation esophagitis [RR=0.49, 95%CI （0.37, 0.66）, P〈0.000 01] and the bone marrow suppression [RR=0.51, 95%CI （0.38, 0.69）, P 〈 0.000 01 ]. Conclusion： Aidi injection in combination with radiotherapy can not only enhance the short-term curative effect, but also improve the quality of life, and decrease the incidence of radiation pneumonitis, radiation esophagitis and bone marrow suppression. However, the quality of RCTs is low, so more clinical trials in high quality were needed to study.