过继免疫治疗联合放化疗治疗非小细胞肺癌的Meta分析  

A Meta-analysis of adoptive immunotherapy combined with chemo/radio therapy in the treatment of non-small cell lung cancer

作　　者：郑雅文[1] 李润美[1] 魏枫[1] 刘亮[1] 张新伟[1] 任秀宝[1] 

机构地区：[1]天津医科大学附属肿瘤医院生物治疗科,天津市肿瘤免疫与生物治疗重点实验室,天津300060

出　　处：《中国肿瘤生物治疗杂志》2013年第4期461-467,共7页Chinese Journal of Cancer Biotherapy

基　　金：国家重点基础研究发展计划(973计划)资助项目(No.2012CB9333004);国家高技术研究发展计划(863计划)资助项目(No.SS2012AA020403);肿瘤医院临床试验专项基金资助项目(No.11L01)~~

摘　　要：目的:探讨过继免疫治疗联合放化疗与单纯放化疗相比对非小细胞肺癌(non-small cell lung cancer,NSCLC)患者疗效的差异。方法:通过检索PubMed、Medline、EMBASE、Cochrane数据库、中国期刊全文数据库和维普中文数据库,收集1995年1月至2012年9月发表的符合要求的随机化对照试验(randomized controlled trial,RCT)或非随机同期对照试验(non-randomized concurrent controlled trail,NRCCT),应用Revman5.0软件进行数据分析。结果:共纳入10项研究,共计1 326名患者。Meta分析结果显示:与单纯放化疗相比,过继免疫治疗联合放化疗能够提高患者2年无进展生存(progression-free surviv-al,PFS)(OR=2.20,95%CI:1.44～3.36,P=0.0003)和2年总生存(OR=2.69,95%CI:1.92～3.78,P<0.00001)。接受过继免疫治疗后,早期和进展期NSCLC患者都能得到较大的获益[(OR=3.24(1.65～6.35);OR=2.86(1.37～5.98)]。过继免疫治疗引起的不良反应多呈自限性,主要有发热、寒战、恶心、乏力等,未观察到严重毒性反应。结论:过继免疫治疗联合放化疗能延缓NSCLC复发,提高患者生存期,且早期患者接受免疫治疗获益更显著。Objective：To systematically assess the therapeutic effectiveness of adoptive immunotherapy combined with chemo/radio therapy compared with chemo/radio therapy alone in non-small cell lung cancer （NSCLC） patients, neth- otis： A systematic search of Pubmed, Medline, EMBASE, Cochrane Library, CNKI and VIP database from January 1995 to September 2012 was performed to identify the eligible randomized controlled trials （RCTs） and non-randomized concur- rent controlled trails （NRCCTs）. The improper documents were excluded. The soft-ware Revman5.0 was used for data synthesis. Results： A total of 10 studies involving 1 326 patients were identified. The result of Meta-analyses showed that adoptive immunotherapy combined with radio/chemo therapy improved the 2-year progression-free survival （PFS） （ OR = 2.20, 95%CI：1.44-3.36, P=0.0003） and 2-year overall survival （0R=2.69, 95%CI：1.92-3.78, P〈 0. 00001 ）. Both early-stage and advanced NSCLC patients benefited from adoptive immunotherapy （ OR = 3.24 [ 1.65 - 6.35 ] ; OR = 2.86[ 1.37 - 5.98 ] ）. The adverse events were self limiting, including fever, chill, nausea, and fatigue. No severe toxicity was observed. Conclusion： Adoptive immunotherapy combined with chemo/radio therapy can decrease the risk of recurrence and improve the overall survival of NSCLC patients ; early-stage patients receiving adoptive immuno- therapy may benefit more.

关 键 词：过继免疫治疗 非小细胞肺癌 化疗 放疗 META分析 联合治疗 

分 类 号：R734.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]