含奈达铂与含顺铂化疗方案对晚期非小细胞肺癌疗效与不良反应比较的Meta分析  

Meta-analysis of comparing nedaplatin-containing chemotherapy with cisplatin-containing chemotherapy in the treatment of advanced non-small cell lung cancer

作　　者：罗龙[1] 周天骏[2] 姚和瑞[1] 

机构地区：[1]中山大学孙逸仙纪念医院肿瘤化疗科,广州510120 [2]中山大学孙逸仙纪念医院心胸外科,广州510120

出　　处：《中华临床医师杂志（电子版）》2012年第21期6803-6807,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金资助课题(30973505;30945201);广东省科技计划资助课题(2009B030801005);广州市科技计划资助课题(2009Y-C011-1)

摘　　要：目的系统评价和比较含奈达铂或顺铂的化疗方案在晚期非小细胞化疗中的疗效、不良反应等。方法在Medline、Embase、Cochrane图书馆、临床试验注册库、中国医院数字化图书馆、万方、维普数据库和美国及欧洲临床肿瘤学历年会议中检索有关晚期非小细胞肺癌患者使用奈达铂或顺铂方案化疗对比的随机临床试验,按Meta分析软件(RevMan 5.1)要求处理有关数据。结果入选6篇文献,试验组与对照组分别为380例与362例。含奈达铂与含顺铂方案相比,客观有效率无统计学差异[OR=1.03,95%CI(0.75,1.41),P=0.84],而Ⅲ～Ⅳ级恶心、呕吐发生率明显降低[OR=0.22,95%CI(0.14,0.324),P<0.00001],肾脏毒性发生率明显降低[OR=0.41,95%CI(0.22,0.75),P=0.004]。血液性毒性较顺铂组高[OR=1.34,95%CI(1.00,1.80),P=0.05]。结论奈达铂与顺铂相比在客观有效率方面无统计学差异,恶心、呕吐、肾脏毒性的反应较顺铂明显降低,而血液性毒性较顺铂组高。有希望成为顺铂的替代方案。然而远期生存率等指标比较尚需进一步大规模的临床试验证实。Objective To investigate the efficacy and side effect of nedaplatin and cisplatin in the treatment of advanced non-small cell lung cancer.Methods To search all of randomized controlled trials on chemotherapy containing nedaplatin or cisplatin in the treatment of advanced non-small cell lung cancer in Medline,Embase,Cochrane library,Clinical trials,CHKD,Wanfang database,VIP information and the data of American and Europe cancer conferences.A Meta-analysis was carried out by RevMan 5.1.Results Six settings with 380 patients in study group and 362 patients in control group were selected.There was no statistical difference between the study group(containing nedaplatin)and the control group(containing cisplatin)in objective response rate[OR=1.03,95% CI(0.75,1.41),P=0.84].The nausea and vomiting rate[OR=0.22,95% CI(0.14,0.324),P<0.00001]and renal toxicity rate[OR=0.41,95% CI(0.22,0.75),P=0.004]were significant lower in study group than control group.However,the hematological toxicity rate of nedaplatin was higher than cisplatin[OR=1.34,95% CI(1.00,1.80),P=0.05].Conclusions Nedaplatin is an effective platinum for non-small cell lung cancer.Nedaplatin has the similar short term effect and better clinical tolerance than cisplatin.Therefore,it can be an acceptable therapeutic option for advanced non-small cell lung cancer.However the long term effect of nedaplatin needs to be proven by large-scale clinical trials.

关 键 词：顺铂 癌 非小细胞肺 META分析 奈达铂 

分 类 号：R734.2[医药卫生—肿瘤]