铂类联合伊立替康与铂类联合依托泊苷一线治疗广泛期小细胞肺癌的系统评价研究

Irinotecan Compared with Etoposide in Combination with Platinum in the First-line Treatment for Extensive Stage Small Cell Lung Cancer:A Systemic Review

[目的]采用Meta分析评价铂类联合伊立替康与铂类联合依托泊苷一线治疗广泛期小细胞肺癌的疗效,为临床用药提供参考。[方法]计算机检索Pub Med、Clinical Trials.gov、CNKI中文数据库,按照纳入与排除标准筛选关于铂类联合伊立替康（IP方案）与铂类联合依托泊苷（EP方案）一线治疗广泛期小细胞肺癌的临床研究,并使用Rev Man5.4.1和Stata11.0进行统计分析。[结果]IP方案一线治疗广泛期小细胞肺癌患者可显著延长总生存期,生存获益优于EP方案,合并HR为0.85（95%CI：0.78～0.92）。在亚洲人群中,相比EP方案,IP方案一线治疗可提高患者客观反应率,合并OR为1.66（95%CI：1.04～2.65）。患者对IP方案的耐受良好,治疗相关死亡的发生与EP方案无差异,OR为1.11（95%CI：0.49～2.50）。[结论]铂类联合伊立替康可作为小细胞肺癌的标准一线治疗方案。

[Purpose] To compare the efficacy of irinotecan/platinum（IP） with etoposide/platinum（EP） in patients with previously untreated extensive stage small cell lung cancer. [Methods] The Pub Med database,Clinical Trials.gov and Chinese National Knowledge Infrastructure were searched. Summary odds ratio（OR） or hazard ratio（HR） and 95% confidence interval（95%CI）were used to compare therapeutic effect of IP and EP in first-line treatment for small cell lung cancer.[Results] Irinotecan combinations versus etoposide regimens stated an overall survival improvement in favor of IP arm,the pooled HR was 0.85（95%CI：0.78～0.92）. The pooled OR indicated that IP regimens could acquire more objective overall response than EP regimens（OR =1.66,95% CI：1.04 ～2.65）. Treatment-related deaths were comparable between the two groups.[Conclusion] IP regimens might be strongly considered as a standard first-line treatment for patients with extensive stage small cell lung cancer.