贝伐单抗联合培美曲塞加顺铂治疗晚期非小细胞肺癌疗效与安全性的Meta分析  

Meta-analysis of efficacy and security of bevacizumab combined with pemetrexed and plus cisplatin in the treatment of advanced non-small cell lung cancer

作　　者：赵钰玲[1,2] 董娅[1,2] 范亚莉[1,2] 杨拴盈[3] 鱼军[4] 王一理[5] 李建英[1] 

机构地区：[1]西安交通大学医学院附属西安市中心医院呼吸内科,陕西西安710003 [2]延安大学医学院,陕西延安716000 [3]西安交通大学附属第二医院呼吸内科,陕西西安710003 [4]西安交通大学医学院附属西安市中心医院急诊科,陕西西安710003 [5]西安交通大学医学部基础医学院癌症研究所,陕西西安710061

出　　处：《现代肿瘤医学》2017年第12期1903-1910,共8页Journal of Modern Oncology

基　　金：陕西省自然科学基础研究计划项目(编号:2012JC2-06);陕西省科学技术研究发展计划项目(编号:2014K11-01-02-15)

摘　　要：目的:系统评价贝伐单抗联合培美曲塞加顺铂治疗晚期非小细胞肺癌(NSCLC)的疗效与安全性。方法:计算机检索Pub Med、Medline、CNKI、VIP和万方医学网等数据库,纳入贝伐单抗联合培美曲塞加顺铂比较治疗晚期非小细胞肺癌的临床随机对照试验,检索时间截至2016年11月。对所检索文献进行文献筛选、资料提取和方法学质量评价后,采用Rev Man5.3.0软件进行Meta分析。结果:共纳入10个研究,合计1 094例患者。研究结果显示:在疗效评价方面,含贝伐单抗治疗的观察组在客观有效率(OR=2.63,95%CI:2.04~3.38,P<0.000 01)、中位无进展生存期(m PFS)(χ~2=15.976,P=0.016 17)方面与不含贝伐单抗的对照组的差异有统计学意义,观察组的疗效明显高于对照组;而在疾病控制率、m OS及安全性方面,贝伐单抗组疾病控制率(OR=2.52,95%CI:1.88~3.38,P<0.000 01)、中位生存期(m OS)(χ~2=5.316 2,P=0.050 02)、恶心、呕吐(OR=0.87,95%CI:0.64~1.19,P=0.38),血小板减低(OR=1.01,95%CI:0.61~1.68,P=0.96),中性粒细胞减低(OR=1.3 8,9 5%CI:0.9 0~2.1 2,P=0.1 4)及贫血(OR=0.99,95%CI:0.46~2.12,P=0.97)的发生率与不含贝伐单抗组相同。但是高血压(OR=3.92,95%CI:1.05~14.62,P=0.04)、出血(OR=5.29,95%CI:0.87~32.31,P=0.07)的发生率却明显高于不含贝伐单抗组。结论:贝伐单抗联合培美曲塞加顺铂比培美曲塞加顺铂治疗非小细胞肺癌的疗效较高,不良反应较少。Objective： To evaluate the dispute on the superiority of the bevacizumab versus pemetrexed plus cisplatin for treating advanced non-small cell lung cancer（ NSCLC）,this study was conducted to evaluate the efficacy and safety of the Bevacizumab verus pemetrexed plus cisplatin for patients with NSCLC.Methods： Such databases as Pub Med,Medline,CNKI,VIP were searched to collect the randomized controlled trials（ RCTs） about bevacizumab versus pemetrexed plus cisplatin for the treatment of NSCLC published before November 2016.Screened the studies,extracted the data and assessed the methodology quality.Rev Man5.3.0 sot ware was used for Meta-analyses.Results： Ten studies involving 1 094 patients were included.The results of Meta-analyses showed that.In terms of the therapeutic evaluation,there was signifcant between the observation group with bevacizumab treatment and the control group without bevacizumab in the objective response rate（ OR=2.63,95% CI： 2.04 ~ 3.38,P 〈0.000 01）,median progression-free survival（ m PFS）（ χ~2= 15.976,P=0.016 17）.The observation group has better effect obviously than the control group.While in disease control rate and safety,the disease control rate（ OR=2.52,95% CI： 1.88 ~3.38,P〈 0.00001）,median overall survival（ m OS）（ χ~2= 5.3162,P=0.05002）,nausea and vomiting（ OR=0.87,95% CI： 0.64 ~ 1.19,P=0.38）,thrombocytopenia（ OR=1.01,95% CI： 0.61 ~ 1.68,P=0.96）,neutropenia（ OR=1.38,95% CI： 0.90 ~ 2.12,P=0.14） and anemia（ OR=0.99,95% CI： 0.46 ~ 2.12,P=0.97） of observation group is the same with the control group.However,the hypertension（ OR=3.92,95% CI： 1.05 ~ 14.62,P =0.04）,and hemorrhage（ OR=5.29,95% CI： 0.87 ~ 32.31,P=0.07） of the observation group with bevacizumab treatment is visibly higher than the control group.Conclusion： The use of bevacizumab combined pemetrexed plus cisplatin has better effect and less untoward effect than pemetrexed plus cisplatin in the treatment of non-small cell lung cancer.

关 键 词：贝伐单抗 培美曲塞 顺铂 非小细胞肺癌 META分析 

分 类 号：R734.2[医药卫生—肿瘤]