EGFR-TKI联合全脑放疗治疗晚期非小细胞肺癌脑转移的疗效与安全性的Meta分析  

EGFR-TKI Combined with WBRT for NSCLC Complicating with Brain Metastasis:A Meta-analysis

作　　者：王宇[1] 柳汝明[2] 徐颖颖[1] 张相彩[1] 王怀冲[1] 

机构地区：[1]杭州市红十字会医院药剂科,杭州310006 [2]昆明医科大学第一附属医院临床药学科,昆明650031

出　　处：《中国药房》2014年第28期2651-2655,共5页China Pharmacy

摘　　要：目的:系统评价表皮生长因子受体酪胺酸激酶抑制剂(EGFR-TKI)联合全脑放射治疗晚期非小细胞肺癌(NSCLC)脑转移的有效性与安全性。方法:计算机检索PubMed、EMBase、Cochrane Library、Science Citation Index、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库、万方数据库纳入的有关EGFR-TKI联合全脑放疗治疗晚期NSCLC脑转移的随机对照试验(RCT),采用Cochrane协作网提供的Rev Man 5.0统计软件进行Meta分析。结果:共纳入7项研究,合计531例患者。Meta分析结果显示,试验组患者的完全缓解率[OR=2.24,95%CI(1.05,4.77),P=0.04]、部分缓解率[OR=2.98,95%CI(1.92,4.63),P<0.000]均显著高于对照组,两组比较差异有统计学意义。试验组患者除皮疹发生率显著高于对照组外[OR=12.27,95%CI(2.58,58.42),P<0.05],其余不良反应发生率与对照组比较,差异无统计学意义。结论:EGFR-TKI联合全脑放疗治疗晚期NSCLC脑转移疗效优于单独全脑放疗,且基本不增加放疗的不良反应。由于纳入研究质量不高、样本量较小,该结论尚需高质量、大样本的RCT进一步证实。OBJECTIVE：To evaluate the effectiveness of EGFR-TKI combined with whole brain radiation therapy（WBRT）for NSCLC complicating with brain metastasis. METHODS：The inclusion and exclusion criteria were established. The literatures were searched from PubMed,EMBase,Cochrane library,Science Citation Index,Chinese Biomedical Database,Chinese Journal Full-text Database,Chinese Science and Technology Academic Journal,Wanfang Medical Digital Periodicals. RCT about EGFR-TKI combined with WBRT for NSCLC complicating with brain metastasis,cohort study and case-control study were included.Meta-analysis was conducted by using Cochrane Collaboration＇s RevMan5.0 software,and the heterogeneous data was analyzed by descriptive qualitative analysis. RESULTS：7 studies were included,involving 531 patients. Meta-analysis results showed that：complete remission rate of trial group [OR=2.24,95%CI（1.05,4.77）,P=0.04] was significantly higher than control group [OR=2.98,95%CI（1.92,4.63）,P〈0.000];there was statistical significance. The incidence of erythra in trial group was significantly higher than in control group [OR=12.27,95%CI（2.58,58.42）,P〈0.05],and there was no statistical significance in the incidence of other ADR between 2 groups. CONCLUSIONS：EGFR-TKI combined with WBRT is more effective than WBRT alone for NSCLC complicating with brain metastasis,and doesn＇t influence ADR induced by radiotherapy. Due to low quality and small-scale samples,more high quality and large-scale RCT are required for further validation of the conclusion.

关 键 词：非小细胞肺癌脑转移 表皮生长因子受体酪胺酸激酶抑制剂 有效率 META分析 

分 类 号：R730.53[医药卫生—肿瘤]