^(125)I粒子植入放射治疗联合含铂化疗方案治疗晚期非小细胞肺癌疗效及安全性的Meta分析

Meta-analysis of effectiveness and safety of ^(125)I seed implantation combined with platinum-based chemotherapy in the treatment of advanced non-small cell lung cancer

目的系统评价^(125)I粒子植入放射治疗联合化疗与单纯化疗在晚期非小细胞肺癌(NSCLC)中的疗效与安全性。方法检索Pub Med、EMBASE、The Cochrane Library、中国生物医学文献数据库(CBM)及中国期刊全文数据库(CNKI)等电子数据库,检索日期为数据库建立至2015年5月。纳入^(125)I粒子植入放射治疗联合含铂化疗方案治疗晚期NSCLC的随机对照试验(RCT),并用Rev Man 5.3统计软件进行Meta分析。结果按照标准共纳入9项研究,包括723例晚期NSCLC患者。Meta分析结果显示:与单纯化疗相比,^(125)I粒子植入联合化疗组治疗晚期NSCLC的有效率(OR=4.59,95%CI:3.24~6.51,P<0.05),临床获益率(OR=4.01,95%CI:2.32~6.92,P<0.05),1年生存率(OR=2.60,95%CI:1.45~4.67,P<0.05)均显著提高,同时不显著增加重度白细胞减少发生率(P>0.05)。结论在晚期NSCLC的治疗中,^(125)I粒子植入放疗联合含铂化疗较单纯化疗可提高疗效,同时具有良好的安全性。

Objective To systematically evaluate the clinical efficacy and safety of 125I seed implantation combined with platinum-based chemotherapy and chemotherapy alone in advanced non-small cell lung cancer （NSCLC）. Methods The following databases such as PubMed, EMBASE, The Cochrane Library, Chinese Biomedical Literature Database （CBM）, and China Academic Journal （CNKI） were retrieved from the time of the database established to May 2015. Randomized controlled clinical trials （RCTs） that comparing the 125I seed implantation combined with platinum-based chemotherapy versus chemotherapy alone in recurrent advanced NSCLC were included and RewMan 5.3 software was used to perform Meta-analysis. Results 9 RCTs involoving 723 patients with advanced NSCLC were adopted according to the inclusion criteria. The results of Meta-analysis showed that compared to chemotherapy group, 125I seed implanta- tion combined with platinum-based chemotherapy could significantly improve the response rate （OR= 4.59, 95%CI： 3.24- 6.51, P 〈 0.05）, clinical benefit rate（OR=4.01, 95%CI：2.32-6.92, P 〈 0.05）, and 1-year survival rate （OR=2.60, 95%C1： 1.45-4.67, P 〈 0.05） in advanced NSCLC, without significantly increase the incidence of severe leukocytopenia （P 〉 0.05）. Conclusion In the treatment of advanced NSCLC, the efficacy of 125I seed implantation combined with platinum- based chemotherapy is better than chemotherapy alone, with tolerable safety.