口服EGFR-TKI药物治疗老年非小细胞肺癌的系统评价被引量：1

Efficacy and safety of EGFR-TKI regimens in the treatment of elderly patients with advanced non-small-cell lung cancer: a systematic review

下载PDF

导出

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.

作者周艳刚王少龙刘朝敏汪力

机构地区成都医学院第一附属医院肿瘤科

出处《海南医学》 CAS 2016年第5期826-830,共5页 Hainan Medical Journal

关键词非小细胞肺癌老年吉非替尼厄洛替尼 EGFR-TKI 系统评价 Non-small-cell lung cancer(NSCLC) Elderly Gefitinib Erlotinib EGFR-TKI Systematic review

分类号 R734.2 [医药卫生—肿瘤]

引文网络
相关文献

参考文献21

1刘鹏辉,廖国清,王红梅,曲怡梅,解国清.吉非替尼和多西他赛+顺铂方案治疗老年晚期非小细胞肺癌的疗效比较[J].中国医院用药评价与分析,2009,9(9):700-702. 被引量：5
2Tudor Ciuleanu,Lilia Stelmakh,Saulius Cicenas,Skaidrius Miliauskas,Alexandru Calin Grigorescu,Carina Hillenbach,Hrefna Kristin Johannsdottir,Barbara Klughammer,Emilio Esteban Gonzalez.??Efficacy and safety of erlotinib versus chemotherapy in second-line treatment of patients with advanced, non-small-cell lung cancer with poor prognosis (TITAN): a randomised multicentre, open-label, phase 3 study(J)Lancet Oncology . 2012 (3)
3Geoffrey Y. Ku,Benjamin A. Haaland,Gilberto de Lima Lopes.??Gefitinib vs. chemotherapy as first-line therapy in advanced non-small cell lung cancer: Meta-analysis of phase III trials(J)Lung Cancer . 2011 (3)
4Tetsuya Mitsudomi,Satoshi Morita,Yasushi Yatabe,Shunichi Negoro,Isamu Okamoto,Junji Tsurutani,Takashi Seto,Miyako Satouchi,Hirohito Tada,Tomonori Hirashima,Kazuhiro Asami,Nobuyuki Katakami,Minoru Takada,Hiroshige Yoshioka,Kazuhiko Shibata,Shinzoh Kudoh,Eiji Shimizu,Hiroshi Saito,Shinichi Toyooka,Kazuhiko Nakagawa,Masahiro Fukuoka.Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial[J]. Lancet Oncology . 2010 (2)
5Randomized phase II trial of gefitinib or gemcitabine or docetaxel chemotherapy in patients with advanced non-small-cell lung cancer and a performance status of 2 or 3 (IFCT-0301 study)(J)Lung Cancer . 2010 (3)
6Kuan-Yu Chen,Jen-Hau Chen,Jin-Yuan Shih,Chih-Hsin Yang,Chong-Jen Yu,Pan-Chyr Yang.??Octogenarians with Advanced Non-small Cell Lung Cancer: Treatment Modalities, Survival, and Prognostic Factors(J)Journal of Thoracic Oncology . 2010 (1)
7Gefitinib versus docetaxel in previously treated non-small-cell lung cancer (INTEREST): a randomised phase III trial(J)The Lancet . 2008 (9652)
8Tanja Cufer,Eduard Vrdoljak,Rabab Gaafar,Inci Erensoy,Kristine Pemberton.??Phase II, open-label, randomized study (SIGN) of single-agent gefitinib (IRESSA) or docetaxel as second-line therapy in patients with advanced (stage IIIb or IV) non-small-cell lung cancer(J)Anti-Cancer Drugs . 2006 (4)
9Shiro Fujita,Nobuyuki Katakami,Katsuhiro Masago,Hiroshige Yoshioka,Keisuke Tomii,Toshihiko Kaneda,Masataka Hirabayashi,Kei Kunimasa,Toshio Morizane,Tadashi Mio.Customized chemotherapy based on epidermal growth factor receptor mutation status for elderly patients with advanced non-small-cell lung cancer: a phase II trial. BMC Cancer . 2012
10Cappuzzo F,Bartolini S,Ceresoli G L,Tamberi S,Spreafico A,Lombardo L,Gregorc V,Toschi L,Calandri C,Villa E,Crinò L.Efficacy and tolerability of gefitinib in pretreated elderly patients with advanced non-small-cell lung cancer (NSCLC). British Journal of Cancer . 2004

二级参考文献54

1霍伟,冯仲珉,赵卫红,张咏梅,刘晓丹,董华承.吉非替尼治疗晚期非小细胞肺癌64例[J].临床肿瘤学杂志,2005,10(1):4-7. 被引量：23
2Scagliotti GV, De Marinis F, Rinaldi M, et al. Phase Ⅲ randomized trial compring three platinum - based doublets in advanced non- small cell lung cancer [ J ]. Clin Ortcol, 2002,20(21 ) :4 285.
3Chang GC, Tsai CM, Chen KC, et al. Predictive factors of predictive factors of gefitinib antitumor activity in east asian advanced non- small cell lung cancer patients [J]. Thorac Oncol, 2006,1 (6) : 520.
4Fukuoka M. Epidermal growth factor receptor tyrosine kinase inhibitors: single agent therapy [ J ]. Lung Cancer, 2003,41 (Suppl2) : BS38.
5Xu JM, Paradiso A, Mcleod HL. Evaluation of epidermal growth factor receptor tyrosine kinase inhibitor combined with chemotherapy: is there a need for more rational design[J]? Eur J Cancer,2004, 40(12) : 1 807.
6孙燕,石远凯.肿瘤内科学手册[M].第5版,北京:人民卫生出版社,2007.73.
7Yancik R, Ries LAG. Cancer and aging in America- Demographic and epidemiologic perspectives [J]. Hematol Oncol Clin North Am, 2000, 14 (1): 17-23.
8Gridelli C, Maione P, Colantoni G, et al. Chemotherapy of non- small cell lung cancer in elderly Patients [J]. Current medicinal chemistry., 2002, 9 (16): 1487-1495.
9Rossi A, Gridelli C. Chemotherapy of advanced non-small cell lung cancer in elderly patients [J]. Annals OF Oncology, 2006, 17 (Suppl. 2) : 58-60.
10Meriggi F, Zaniboni A. Non-small-cell lung cancer in the elderly [J]. Critical Reviews In Oncology, 2006, 57 (2): 183-190.