阿帕替尼联合多西他赛治疗一线治疗失败非小细胞肺癌疗效的Meta分析

A meta-analysis of the efficacy of apatinib combined with docetaxel for first-line failed non-small cell lung cancer

目的用Meta分析评价阿帕替尼联合多西他赛治疗一线治疗失败的非小细胞肺癌的疗效。方法检索PubMed、FMRS、CNKI、和万方医学网等数据库,检索时间截至2020年3月,纳入的临床随机对照试验是指研究阿帕替尼联合多西他赛对一线治疗失败的非小细胞肺癌的疗效。被检索文献经筛选后提取资料、Cochrane系统评价方法学质量评价,进而采用Rev Man 5.3.0软件进行Meta分析。结果共纳入7个临床试验研究,合计765例。阿帕替尼联合多西他赛针在治疗一线治疗失败的非小细胞肺癌具有更高的疾病控制率,与阿帕替尼单药相比,差异有统计学意义(OR=4.55,P<0.0001,95%CI=3.25~6.38);用药过程中虽仍会出现与药物相关的不良反应,但两组相比较,高血压(OR=0.75,P=0.77,95%CI:0.11~5.04)、蛋白尿(OR=1.10,P=0.91,95%CI:0.21~5.78)和手足综合征(OR=1.90,P=0.15,95%CI:0.80~4.52)发生率差异无统计学意义,惟胃肠道反应(OR=2.34,P<0.001,95%CI:1.44~3.81)的发生率联合用药组高于单药治疗组,差异有统计学意义。结论在一线治疗失败的非小细胞肺癌的治疗中,阿帕替尼联合多西他赛取得显著疗效,临床值得推广。

Objective To evaluate the efficacy of apatinib combined with docetaxel in the treatment of non-small cell lung cancer that has failed first-line treatment.Methods Databases such as PubMed,FMRS,CNKI and wanfang medical network were searched by March 2020.The included randomized controlled clinical trials refer to the efficacy study of apatinib combined with docetaxel in nonsmall cell lung cancer patients with first-line treatment failure.The retrieved literature was screened and extracted,the Cochrane systematic review methodology was evaluated for quality,and then the Rev Man5.3.0 software was used for Meta-analysis.Results A total of 7 clinical trials were included,with a total of 765 patients.Apatinib combined with docetaxel had a higher disease control rate in the firstline treatment of non-small cell lung cancer,compared with apatinib alone,the difference was statistically significant(OR=4.55,P<0.0001,95%CI=3.25-6.38);although there were still drug-related adverse reactions in the process of medication,the incidence of adverse reactions in the two groups with hypertension(OR=0.75,P=0.77,95%CI:0.11-5.04)and proteinuria(OR=1.10,P=0.91,95%CI:0.21-5.78)and hand-foot syndrome(OR=1.90,P=0.15,95%CI:0.80-4.52)was no statistically significant difference.Gastrointestinal reactions(OR=2.34,P<0.001,95%CI:1.44-3.81)were higher than those of the control group,the latter was statistically significant.Conclu⁃sion Apatinib combined with docetaxel has achieved significant results in the treatment of non-small cell lung cancer patients with first-line treatment failure,and it is clinically worthy of promotion.