奥沙利铂与卡铂治疗中晚期非小细胞肺癌的meta分析  

Meta-analysis of oxaliplatin versus carboplatin based chemotherapy in treatment of advanced NSCLC

作　　者：杜习智[1] 赵成龙[1] 秦玉花[1] 赵红卫[1] 

机构地区：[1]河南省人民医院药学部,郑州450003

出　　处：《郑州大学学报（医学版）》2015年第4期550-555,共6页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的：：系统评价奥沙利铂联合化疗与卡铂联合化疗治疗中晚期非小细胞肺癌（NSCLC）的有效性和安全性。方法：检索 Medline、Cochrane Library、PubMed、EMbase、CNKI、CBM、VIP 和 WANFANG 数据库,收集关于奥沙利铂联合化疗与卡铂联合化疗治疗中晚期 NSCLC 的随机对照试验（RCT）,采用 RevMan 5.1进行 meta 分析。结果：最终纳入6个 RCT,共784例患者。 Meta 分析显示,两个方案的客观缓解率（OR =0.82,95% CI：0.60～1.14）、客观控制率（OR =0.97,95% CI：0.72～1.31）、Ⅲ-Ⅳ度恶心、呕吐发生率（OR =1.02,95% CI：0.55～1.91）差异无统计学意义,而奥沙利铂联合方案Ⅲ-Ⅳ度贫血（OR =0.18,95% CI：0.05～0.63）、Ⅲ-Ⅳ度白细胞减少（OR =0.29,95%CI：0.15～0.57）、Ⅲ-Ⅳ度中性粒细胞减少（OR =0.41,95% CI：0.28～0.61）、Ⅲ-Ⅳ度血小板减少（OR =0.20,95%CI：0.05～0.71）的发生率较卡铂联合方案明显降低,神经毒性的发生率明显升高（OR =30.58,95% CI：7.17～130.38）。结论：奥沙利铂联合化疗方案治疗中晚期 NSCLC 疗效与卡铂联合化疗方案相似,但安全性更好。Aim： To determine the efficacy and toxicity of oxaliplatin based chemotherapy versus carboplatin based chemotherapy for advanced non-small cell lung cancer（NSCLC）. Methods： The randomized controlled trials（RCTs） on oxaliplatin based chemotherapy versus carboplatin based chemotherapy for advanced NSCLC were searched in Medline, the Cochrane Library, PubMed, EMbase, CNKI, CBM, VIP and WANFANG Data base. A meta-analysis was carried out by RevMan 5. 1. Results： Six trials that included a total of 784 patients were analyzed. The meta-analysis demonstrated that, compared with the carboplatin based chemotherapy, oxaliplatin based chemotherapy could decrease the risks of hematologi-cal toxicity, including grade 3 - 4 anemia（OR = 0. 18, 95% CI：0. 05 - 0. 63）, grade 3 - 4 leukopenia（OR = 0. 29, 95%CI：0. 15 - 0. 57）, grade 3 - 4 neutropenia （OR = 0. 41, 95% CI：0. 28 - 0. 61）, and grade 3 - 4 thrombocytopenia（OR =0. 20, 95% CI：0. 05 - 0. 71）, but increase the risk of neurotoxicity（OR = 30. 58, 95% CI：7. 17 - 130. 38）. There were no significant differences between the two groups in overall response rate（OR = 0. 82, 95% CI：0. 60 - 1. 14）, disease con-trol rate（OR = 0. 97, 95% CI：0. 72 - 1. 31）, or grade 3-4 nausea and vomiting（OR = 1. 02, 95% CI：0. 55 - 1. 91）. Con-clusion： Oxaliplatin based chemotherapy has similar efficacy to carboplatin based chemotherapy, but milder toxicity.

关 键 词：奥沙利铂 卡铂 非小细胞肺癌 META 分析 

分 类 号：R734.2[医药卫生—肿瘤]