摘要
目的系统评价使用EGFR-TKI药物一线治疗非选择性老年晚期非小细胞肺癌患者的有效性及安全性。方法使用计算机对Cochrane图书馆、Pub Med、Embase、CNKI、CBM等数据库(截止2015年4月)进行检索,从中纳入所有随机对照试验,进行系统评价。结果纳入3篇文献、共326例老年晚期非小细胞肺癌患者进入Meta-分析,结果显示:厄洛替尼或吉非替尼与长春瑞宾、紫杉醇单药或双药联合化疗等治疗方案相比,有效率(RR=0.91,95%CI:0.56~1.49,P=0.72)及肿瘤控制率均差异无统计学意义(RR=0.96,95%CI:0.79~1.17,P=0.68),且在中位无疾病进展时间及中位生存时间等方面差异无统计学意义。EGFR-TKI药物主要不良反应为皮疹、腹泻,其消化道和血液系统毒性与化疗相比较轻。结论在未行基因检测的非选择性老年晚期NSCLC患者中给予口服EGFR-TKI药物(吉非替尼或厄洛替尼)安全性较好,可获得与化疗药物相似疗效。
Objective To evaluate the clinical efficacy and safety of EGFR-TKI regimen in the treatment of elderly patients with advanced non-small-cell lung cancer(NSCLC) patients by meta-analysis. Methods We searched the randomized controlled trials(RCTs) till Apr. 2015 in Cochrane Library, Pub Med, Embase, China Biology Medicine(CBM), China National Knowledge Infrastructure(CNKI) database. Meta-analysis were performed by Rev Man 5.0 software. Results Three RCTs involving 326 elderly patients with advanced NSCLC were included. Meta-analysis revealed that EGFR-TKI regimen(Erlotinib or Gefitinib) showed no statistically significant difference in effective rate(RR=0.91, 95%CI: 0.56~1.49, P=0.72), tumor growth control rates(RR=0.96, 95%CI: 0.79~1.17, P=0.68), median progression-free survival, median overall survival when compared to chemotherapy. The major adverse reactions for EGFR-TKI regimen were rash and diarrhea. EGFR-TKI regimen showed lower digestive and hematology toxicity than chemotherapy. Conclusion EGFR-TKI regimen shows similar efficacy with chemotherapy in the treatment of elderly patients with advanced NSCLC, with good safety.
出处
《海南医学》
CAS
2016年第5期826-830,共5页
Hainan Medical Journal