IP与TP方案二线治疗小细胞肺癌疗效及安全性的Meta分析

Effectiveness and safety of IP and TP regimens for second-line treatment of SCLC: A Meta-analysis

目的:评价IP方案(伊立替康联合顺铂)对比TP方案(紫杉醇联合顺铂)二线治疗小细胞肺癌的有效性和安全性。方法:计算机检索The Cochrane Library、Pubmed、Embase、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、维普中文科技期全文数据库(VIP)和万方数据库,对符合纳入标准的随机对照试验进行方法学质量评价,采用Rev Man 5.3进行Meta分析。结果:共纳入4个研究307例患者,结果显示,IP方案和TP方案二线治疗小细胞肺癌,在完全缓解率、部分缓解率、有效率方面,两组无统计学差异(P>0.05);在毒副反应方面,两组的Ⅲ-Ⅳ级消化道反应、Ⅲ-Ⅳ级延迟性腹泻、Ⅲ-Ⅳ级白细胞减少、Ⅲ-Ⅳ级血小板减少均无统计学差异(P>0.05)。结论:现有证据表明,对于小细胞肺癌的二线治疗,IP方案与TP方案近期疗效相当,Ⅲ-Ⅳ级的毒副反应无差异,但受纳入研究的数量及质量的影响,上述结论尚需更多高质量的临床试验来进一步证实。

Objective ： To evaluate the effectiveness and safety of CPT - 11 combined with DDP and PTX combined with DDP for second - line treatment of SCLC. Methods： Four databases were searched, including The Cochrane Li- brary, Pubmcd, Embase, CBM, CNKI, VIP, Wanfang Database, and the methodological quality assessment of RCTs in- cluded was conducted according to the methods of Cochrane collaboration. The Meta - analysis were performed by using the RevMan 5.3 software. Results ：4 RCTs containing 307 patients were finally included. In the second -line treatment of SCLC, there were no significant differences in the rate of CR, PR, and the effective rate between the two groups（P 〉 0.05）. There were also no significant differences in the Ⅲ-Ⅳ grade side reaction between the two groups （P 〉 0.05）. Conclusion ： Current evidence shows that there is no differences in the second -line treatment of SCLC between the IP and TP regimen in the short - term clinical efficacy. There was also no significant differences in the grade Ⅲ-Ⅳ side reactions between the two groups. For the quality of included study, the conclusion needs more high - quality clinical researchs to support.