EGFR-TKIs治疗老年EGFR敏感突变型非小细胞肺癌患者临床效果的meta分析

Efficacy of EGFR tyrosine kinase inhibitors in elderly patients with EGFR-mutated non-small cell lung cancer:a meta analysis

目的:通过meta分析评价EGFR络氨酸激酶抑制剂(EGFR-TKIs)在EGFR敏感突变型老年晚期非小细胞肺癌(NSCLC)患者中的疗效。方法:计算机检索PubMed、Cochrane library、Embase、中国知网(CNKI)等数据库,全面搜集EGFRTKIs与化疗的随机临床对照试验(RCT),提取各RCT中年龄≥65岁和<65岁患者无进展生存时间(PFS)的风险比(HR)和95%可信区间(CI),荟萃亚组分析EGFR-TKIs在年龄≥65岁和<65岁的EGFR敏感突变型NSCLC患者中的临床疗效。结果:共纳入4个RCTs,包括1 036例患者,荟萃分析结果显示,EGFR敏感突变型晚期NSCLC患者经EGFR-TKIs治疗后,EGFR敏感突变型NSCLC接受EGFR-TKIs相比化疗可以延缓PFS(HR=0.32,95%CI:0.23~0.44;P<0.0001);亚组分析年龄≥65岁的老年患者PFS进展风险(HR=0.28)低于年龄<65岁患者(HR=0.34)。结论:EGFR-TKIs可以显著延缓EGFR敏感突变型晚期NSCLC患者的PFS,且在老年患者中表现出一定的优势,对此部分老年患者,EGFR-TKIs是较好的治疗选择之一。

Objective:We performed a meta-analysis to assess the efficacy of epidermal growth factor recep-tor tyrosine kinase inhibitors(EGFR-TKIs)in elderly patients with EGFR-mutated non-small cell lung cancer(NSCLC).Methods:A meta-analysis of the results of randomized clinical trial was undertaken.Rele-vant publications from PubMed the Cochrane library,Embase,CNKI were searched.We retrieved the haz-ard ratio(HR)and 95%conference interval(CI)for progression free survival(PFS)of the intention-to-treat population and age defined subgroup.Results:Four randomized controlled trials(RCTs)were in-volved,which consisted of 1,036 patients,the pool analysis reveal an overall significant improvement in PFS(HR=0.32,95%Cl:0.23-0.44;P〈0.0001)with the use of EGFR-TKIs in EGFR-mutated NSCLC.Subgroup meta-analysis suggested that EGFR-TKIs was effective in prolonging PFS in elderly patients(HR=0.28)in comparison with young patients(HR=0.34).(Conclusion:EGFR-TKIs had a good effect in delaying diseases progression in elderly patients with advanced EGFR-mutated NSCLC.It was a great valid option in this age group.