含洛铂化疗方案治疗小细胞肺癌疗效和安全性的系统分析  

Efficacy and safety of lobaplatin-based chemotherapy in the treatment of small cell lung cancer: A meta-analysis

作　　者：徐轲[1] 张妍蓓[1] 张晶晶[2] 

机构地区：[1]安徽医科大学第一附属医院老年呼吸内科,安徽合肥230022 [2]安徽医科大学第二附属医院肾脏内科,安徽合肥230601

出　　处：《安徽医药》2015年第11期2187-2191,共5页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省科技攻关项目(No 1501041144)

摘　　要：目的系统评价含洛铂化学治疗方案对小细胞肺癌(SCLC)的疗效和相关副作用。方法根据预先制定的方案中的检索策略检索中英文数据库中相关的随机对照研究(RCT),对纳入文献的方法学质量评价应用改良后的Jadad量表进行,Meta分析使用Stata 12.0软件进行。结果最终入选9篇文章,其中洛铂组共计267例患者,对照组共计243例患者(n=510)。Meta分析结果显示,洛铂组患者的客观缓解率[RR=1.06,95%CI(0.92,1.21),P=0.43],白细胞减低发生率[RR=1.01,95%CI(0.74,1.38),P=0.94],血小板减低发生率[RR=1.42,95%CI(0.78,2.58),P=0.25]和血红蛋白减低发生率[RR=0.82,95%CI(0.34,1.97),P=0.615]与对照组比较均没有统计学差异;洛铂组患者胃肠道症状发生率[RR=0.17,95%CI(0.09,0.32),P<0.001]与对照组比较差异有统计学意义。亚组分析结果显示在复治患者中洛铂组较对照组客观缓解率具有统计学差异[RR=1.43,95%CI(1.00,2.05),P=0.042]。结论含洛铂的化疗方案治疗SCLC患者的疗效与对照组相当,在复治患者中疗效优于对照组,且副作用低于对照组。Objective To assess the clinical efficacy and safety of lobaplatin-based chemotherapy for small cell lung cancer（ SCLC）.Methods Retrieved from databases in English and Chinese,RCTs about lobaplatin-based chemotherapy for SCLC were included. The quality of included studies was evaluated by modified Jadad scale,and all analyses were performed using Stata（ release 12. 0）. Results A total of 9 RCTs involving 510 patients were included. Meta-analysis indicated there was no statistical significance in objective response rate（ ORR） [ RR = 1. 06,95% CI（ 0. 92,1. 21）,P = 0. 43],the incidence of leucopenia [RR = 1. 01,95% CI（ 0. 74,1. 38）,P= 0. 94],thrombocytopenia [RR = 1. 42,95% CI（ 0. 78,2. 58）,P = 0. 25] and anemia[RR = 0. 82,95% CI（ 0. 34,1. 97）,P = 0. 615]in trial groups,compared with control group. The incidence of nausea and vomiting [RR = 0. 17,95% CI（ 0. 09,0. 32）,P〈0. 001] in trial group was significantly lower than in control group. Sub-group analysis showed that lobaplatin-based chemotherapy were more efficacy compared with control group when patients given second therapy[RR = 1. 43,95% CI（ 1. 00,2. 05）,P = 0. 042]. Conclusions Although therapeutic efficacy of lobaplatin-based chemotherapy is similar to control chemotherapy for SCLC,but the former is safer than the latter.

关 键 词：小细胞肺癌 洛铂 META分析 随机对照试验 

分 类 号：R734.2[医药卫生—肿瘤]