摘要
目的系统评价厄洛替尼与化疗二线治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的有效性及安全性。方法计算机检索The Cochrane Library(2014年第7期)、Web of Science(1966-2014-07)、EMbase(1900-2014-07)、PubMed(1966-2014-07)、CBM(1978-2014-07)、CNKI(1994-2014-07)和WanFang Data(1989-2014-07),收集厄洛替尼二线治疗晚期NSCLC的临床随机对照试验,2名评价员按照纳入与排除标准筛选文献、提取资料及评价文献质量后,采用RevMan5.2进行荟萃分析。结果最终纳入6个临床随机对照试验,共1 369例患者。荟萃分析结果显示,厄洛替尼与传统化疗相比二线治疗晚期NSCLC患者的无进展生存期(progression-free survival,PFS)(HR=0.98,95%CI为0.86~1.12,P=0.77)和总生存期(overall survival,OS)(HR=0.93,95%CI为0.81~1.07,P=0.31)差异均无统计学意义;亚组分析显示,厄洛替尼与传统化疗在吸烟状况、性别及表皮生长因子受体(epidermal growth factor recepptor,EGFR)野生型患者中PFS和OS差异均无统计学意义;厄洛替尼联合化疗与单纯化疗相比可延长非鳞癌患者的PFS(HR=0.61,95%CI为0.47~0.79,P=0.000 2)和OS(HR=0.71,95%CI为0.54~0.94,P=0.02)。安全性方面,厄洛替尼最主要的不良反应为皮疹和腹泻,与化疗联合使用耐受性良好。结论厄洛替尼对比化疗二线治疗NSCLC在PFS和OS方面并未显示出优势,对于晚期非鳞癌患者来说,厄洛替尼联合化疗可明显延长患者的PFS和OS,厄洛替尼最主要的不良反应为皮疹和腹泻,与化疗联合使用耐受性良好。
OBJECTIVE To systematically evaluate the efficacy and safety of erlotinib versus chemotherapy as sec- ond-line treatment in patients with advanced non-small cell lung cancer (NSCLC). METHODS We searched the Cochrane Library(Issue 7,2014), Web of Science(1966-- 2014-07), EMbase(1900-- 2014-07), PubMed (1966-- 2014-07), CBM (1978--2014-07) ,CNKI(1994--2014-07) and WanFang Data(1989--2014-07). Data Analyses was conducted using Rev- Man5.2 software. RESULTS The final analysis included six trials,covering 1 396 patients. The results of recta-analyses showed that: erlotinib was not significantly improved progression-free survival (PFS) [HR=0.98,95 %CI(0.86--1.12), P= 0.77] and overall survival(OS) [HR= 0.93,95 % CI(0.81 -- 1.07) ,P= 0.31) ]compared with chemotherapy, subgroup analysis showed the PFS and OS in two groups had no significant difference in smoking state and gender as well as in pa- tients with wild-type EGFR~ However, compared with chemotherapy group, erlotinib combined with chemotherapy signifi- cantly improved PFS[HR=0. 61,95% CI(0.47--0.79),P=0.000 2] and OS[HR=0.71,95%CI(0.54--0.94),P= 0. 02)] in second--line non-squamous non-small cell lung cancer. The main adverse reactions caused by erlotinib were tol erable rash and diarrhea. CONCLUSIONS Erlotinib monotherapy in second-line treatment of non-small cell lung cancer did not show superiority, erlotinib in combination with chemotherapy for advanced non-squamous non-small cell lung canc- er prolongs the patienCs PFS and OS. The main adverse reactions caused by erlotinib were tolerable rash and diarrhea.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2015年第8期637-643,共7页
Chinese Journal of Cancer Prevention and Treatment
基金
新疆医科大学第一附属医院青年专项基金(2012QN10)
关键词
癌
非小细胞肺
厄洛替尼
化学治疗
二线治疗
随机对照试验
Meta分析
cancroid,non-srnall cell lung
erlotinib
chemotherapy
second-line therapy
randomized controlled trial
Meta analysis