含铂双药对比非铂单药二线治疗晚期NSCLC的系统评价
发布时间：2018-11-15 19:36
【摘要】：目的：系统评价联合铂类的双药方案和非铂类单药方案二线治疗晚期非小细胞肺癌(NSCLC, non-small-cell lung cancer)患者的有效性及安全性。方法：计算机检索PubMed、The Cochrane Library、Web of science、中国生物医学文献数据库(CBM)、相关期刊论文(CNKI)和万方数据库,收集含铂双药化疗方案对比非铂单药化疗方案二线治疗晚期NSCLC的随机对照试验,用RevMan5.2进行荟萃分析。结果：最终纳入11项临床随机对照试验,共1167例患者。Meta分析结果显示与非铂单药方案相比,含铂双药方案化疗可提高晚期NSCLC患者的化疗客观有效率(ORR)及疾病控制率(DCR),分别为1.43倍(RR=1.43,95%CI:1.08～1.89, P=0.010)和1.16倍(RR=1.16,95%CI:1.05～1.27, P=0.002)。同时,含铂双药方案化疗亦可延长晚期NSCLC患者的无进展生存期(PFS, progression-free survival) (HR=0.74,95%CI:0.58～0.95, P=0.020),但含铂双药化疗与非铂单药化疗两组1年生存率差异无统计学意义(RR=1.21,95%CI:0.91～1.61, P=0.190)。安全性方面,含铂双药方案化疗最主要的不良反应为血小板减少(RR=2.99,95%CI:1.95～4.59, P0.001)；而3/4级白细胞减少、中性粒细胞减少、恶心呕吐、贫血等不良反应,含铂双药化疗组与非铂单药化疗组两组差异均无统计学意义。结论：与非铂单药化疗方案相比,含铂双药方案可提高晚期NSCLC患者化疗客观有效率及疾病控制率,延长晚期NSCLC患者的无进展生存期,但不能明显改善1年生存率。最主要不良反应为血小板减少,低毒耐受性好。因此,含铂双药化疗方案在一线治疗失败的晚期NSCLC患者的二线治疗中值得进一步推广。
[Abstract]:Objective: to evaluate the efficacy and safety of two-line chemotherapy combined with platinum regimen and non-platinum regimen in patients with advanced non-small cell lung cancer (NSCLC, non-small-cell lung cancer). Methods: PubMed,The Cochrane Library,Web of science, Chinese biomedical literature database (CBM), Chinese periodical full-text database (CNKI) and Wanfang database were searched by computer. A randomized controlled trial of two-line chemotherapy regimen containing platinum and two-line non-platinum chemotherapy regimen for advanced NSCLC was collected. RevMan5.2 was used for meta-analysis. Results: a total of 1167 patients were enrolled in 11 randomized controlled trials. The results of Meta analysis were compared with those of non-platinum monotherapy regimen. Dual regimen chemotherapy with platinum can improve the objective effective rate of chemotherapy, (ORR) and disease control rate (DCR), of patients with advanced NSCLC 1.43 times (RR=1.43,95%CI:1.08~1.89,) P0. 010 and 1. 16 times (RR=1.16,95%CI:1.05~1.27, P0. 002). At the same time, combination chemotherapy with platinum could also prolong the progression free survival (PFS, progression-free survival) (HR=0.74,95%CI:0.58~0.95, P0. 020) in patients with advanced NSCLC. However, there was no significant difference in 1-year survival rate between the two groups (RR=1.21,95%CI:0.91~1.61, P0. 190). In terms of safety, thrombocytopenia (RR=2.99,95%CI:1.95~4.59, P0.001) was the main adverse effect of chemotherapy with platinum. However, there were no significant differences in adverse reactions such as 3 / 4 grade leukopenia, neutropenia, nausea, vomiting and anemia between the two groups. Conclusion: compared with non-platinum single-drug chemotherapy regimen, the chemotherapy regimen containing platinum can improve the objective effective rate and disease control rate of patients with advanced NSCLC, prolong the progression-free survival time of patients with advanced NSCLC, but can not obviously improve the 1-year survival rate. The main adverse effects were thrombocytopenia and low toxicity tolerance. Therefore, platinum-containing dual-drug chemotherapy regimen is worthy of further promotion in the second-line treatment of patients with advanced NSCLC who fail in first line treatment.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R734.2
，
本文编号：2334245
[Abstract]:Objective: to evaluate the efficacy and safety of two-line chemotherapy combined with platinum regimen and non-platinum regimen in patients with advanced non-small cell lung cancer (NSCLC, non-small-cell lung cancer). Methods: PubMed,The Cochrane Library,Web of science, Chinese biomedical literature database (CBM), Chinese periodical full-text database (CNKI) and Wanfang database were searched by computer. A randomized controlled trial of two-line chemotherapy regimen containing platinum and two-line non-platinum chemotherapy regimen for advanced NSCLC was collected. RevMan5.2 was used for meta-analysis. Results: a total of 1167 patients were enrolled in 11 randomized controlled trials. The results of Meta analysis were compared with those of non-platinum monotherapy regimen. Dual regimen chemotherapy with platinum can improve the objective effective rate of chemotherapy, (ORR) and disease control rate (DCR), of patients with advanced NSCLC 1.43 times (RR=1.43,95%CI:1.08~1.89,) P0. 010 and 1. 16 times (RR=1.16,95%CI:1.05~1.27, P0. 002). At the same time, combination chemotherapy with platinum could also prolong the progression free survival (PFS, progression-free survival) (HR=0.74,95%CI:0.58~0.95, P0. 020) in patients with advanced NSCLC. However, there was no significant difference in 1-year survival rate between the two groups (RR=1.21,95%CI:0.91~1.61, P0. 190). In terms of safety, thrombocytopenia (RR=2.99,95%CI:1.95~4.59, P0.001) was the main adverse effect of chemotherapy with platinum. However, there were no significant differences in adverse reactions such as 3 / 4 grade leukopenia, neutropenia, nausea, vomiting and anemia between the two groups. Conclusion: compared with non-platinum single-drug chemotherapy regimen, the chemotherapy regimen containing platinum can improve the objective effective rate and disease control rate of patients with advanced NSCLC, prolong the progression-free survival time of patients with advanced NSCLC, but can not obviously improve the 1-year survival rate. The main adverse effects were thrombocytopenia and low toxicity tolerance. Therefore, platinum-containing dual-drug chemotherapy regimen is worthy of further promotion in the second-line treatment of patients with advanced NSCLC who fail in first line treatment.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R734.2
，
本文编号：2334245
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