大剂量顺铂分次给药治疗非小细胞肺癌的近期疗效及安全性的Meta分析

Recent efficacy and safety of divided administration of high dose cisplatin in the treatment of non-small cell lung cancer: A Meta-analysis

目的:采用Meta分析方法对顺铂分次给药治疗非小细胞肺癌的近期疗效及不良反应进行评价。方法:检索Pubmed、EMbase、Cochrane Library、中国知网CNKI全文数据库、维普数据库、万方数据库和中国生物医学文献数据库,查找建库初始至2016年4月公开发表的研究顺铂分次给药治疗非小细胞肺癌的临床随机对照试验。按照纳入与排除标准选择文献,质量评估,资料提取,采用Rev Man 5.2软件进行Meta分析。结果:共纳入6篇中文RCT文献。Meta分析结果显示,顺铂分次给药组与单次给药组在近期疗效上无明显差异[OR=0.81,95%CI(0.57,1.15),P=0.24];顺铂分次给药组发生恶心与呕吐少于单次给药组[OR=0.45,95%CI(0.30,0.69),P=0.000 3];而发生骨髓抑制[OR=0.64,95%CI(0.40,1.01),P=0.06]、肾功能下降[OR=0.74,95%CI(0.30,1.82),P=0.51]和神经毒性[OR=0.38,95%CI(0.13,1.12),P=0.08],与单次给药组无明显差异。结论:大剂量顺铂分次给药,在不降低近期疗效的情况下,减轻了化疗相关性恶心和呕吐,值得广泛应用。

Objective： To evaluate the recent efficacy and safety of divided cisplatin administration in the treatment of non- small cell lung cancer. Methods： Studies were identified by searching Pubmed,EMbase,Cochrane Library,CNKI,VIP,Wanfang and CBM by April 2016. Randomized clinical trials of divided cisplatin administration in the treatment of non- small cell lung cancer were included. Choose studies according to the inclusion and exclusion criteria,and evaluate quality retrieve data. Meta- analysis was performed for the results of studies by using Rev Man 5. 2software. Results： Six studies were included. The results showed： There was no statistically significant difference on recent efficacy between the divided administration group and single administration group[OR = 0. 81,95% CI（ 0. 57,1. 15）,P = 0. 24]. Nausea and vomiting in the divided administration group was significantly lower than that in the single administration group[OR = 0. 45,95% CI（ 0. 30,0. 69）,P = 0. 000 3],but there was no statistically significant difference on bone marrow suppression[OR = 0. 64,95% CI（ 0. 40,1. 01）,P = 0. 06],renal function decline[OR =0. 74,95% CI（ 0. 30,1. 82）,P = 0. 51] and neurotoxicity[OR = 0. 38,95% CI（ 0. 13,1. 12）,P = 0. 08] between the two groups. Conclusion： Divided administration of high dose cisplatin,could reduce chemotherapy- induced nausea and vomiting,without reducing recent efficacy. It was worthy of wide application clinically.