沙利度胺联合紫杉类或长春碱类抗肿瘤药物治疗非小细胞肺癌临床疗效及安全性的Meta分析  

Clinical Effect and Safety of Thalidomide Combined with Taxanes or Vinca Alkaloids on Non-small Cell Lung Cancer:A Meta-analysis

作　　者：曹强[1] 扬扬[1] 许瑞彬[1] 刘延风[1] 

机构地区：[1]延安大学附属医院胸心外科,陕西省延安市716000

出　　处：《实用心脑肺血管病杂志》2015年第7期1-7,共7页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：陕西省卫生科研项目(2014-D27)

摘　　要：目的评价沙利度胺联合紫杉类或长春碱类抗肿瘤药物治疗非小细胞肺癌的临床疗效及安全性。方法计算机检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普网、万方数据知识服务平台、Pub Med、EMBASE、Cochrane Library、Web of science〔科学引文索引扩展版(SCIE)及科学技术会议录索引(CPCI-S)〕等数据库,筛选有关沙利度胺联合紫杉类或长春碱类抗肿瘤药物治疗非小细胞肺癌的随机对照试验(RCT),其中试验组患者采用"紫杉类或长春碱类抗肿瘤药物+沙利度胺"治疗,对照组患者除不给予沙利度胺外,其余治疗药物与试验组相同。比较两组患者临床疗效〔完全缓解(CR),部分缓解(PR),疾病稳定(SD),疾病进展(PD)〕、治疗期间毒副作用(红细胞计数减少、白细胞计数减少、血小板计数减少、恶心呕吐、便秘、脱发)发生率、1年及2年生存率、化疗前后血清血管内皮生长因子(VEGF)水平。结果共纳入10个RCT,总计1 283例患者。Meta分析结果显示,试验组患者PR率〔OR=1.32,95%CI(1.03,1.68),P=0.03〕,1年生存率〔OR=2.32,95%CI(1.35,4.00),P=0.002〕及2年生存率〔OR=3.10,95%CI(1.85,5.20),P<0.000 1〕、恶心呕吐发生率〔OR=0.25,95%CI(0.07,0.95),P=0.001〕高于对照组,试验组患者化疗后血清VEGF水平低于对照组〔MD=-107.49,95%CI(-172.46,-42.53),P=0.002〕。结论沙利度胺联合紫杉类或长春碱类抗肿瘤药物可提高非小细胞肺癌患者PR率及生存率,降低血清VEGF水平,但会增加恶心呕吐发生率。Objective To evaluate the clinical effect and safety of thalidomide combined with taxanes or vinca alkaloids on non-small cell lung cancer. Methods A research was carried out on CBM, CNKI, VIP, Wanfang Data,Pub Med,EMBASE,the Cochrane Library, SCIE and CPCI-S, RCTs about thalidomide combined with taxanes or vinca alkaloids in treating non-small cell lung cancer were enrolled, thereinto patients of test group were treated by thalidomide combined with taxanes or vinca alkaloids, while patients of control group were treated by taxanes or vinca alkaloids without thalidomide. Clinical effect（ CR,PR,SD,PD）,incidence of toxic and side effect during treatment（ decreased red blood cell count,decreased white blood cell count,decreased blood platelet count,nausea and vomiting,astriction,alopecia）,1-year and 2-year survival rate,serum VEGF level before and after chemotherapy were compared between the two groups. Results A total of 10 RCTs were enrolled in this study,including 1 283 patients. Meta-analysis results showed that,PR rate 〔OR = 1. 32,95% CI（ 1. 03,1. 68）,P = 0. 03〕,1-year survival rate 〔OR = 2. 32,95% CI（ 1. 35,4. 00）,P = 0. 002 〕 and 2-year survival rate 〔OR = 3. 10,95% CI（ 1. 85,5. 20） P〈0. 000 1 〕, incidence of nausea and vomiting 〔OR = 0. 25,95% CI（ 0. 07,0. 95） P = 0. 001〕of test group were statistically significantly higher than those of control group,while serum VEGF level of test group was statistically significantly lower than that of control group〔MD =-107. 49,95% CI（-172. 46,-42. 53）,P= 0. 002〕. Conclusion Thalidomide combined with taxanes or vinca alkaloids can improve the PR rate and reduce the serum VEGF level of patients with non-small cell lung cancer,but can also increase the incidence of nausea and vomiting.

关 键 词：癌 非小细胞肺 沙利度胺 紫杉类 长春花生物碱类 META分析 

分 类 号：R734.2[医药卫生—肿瘤]