培美曲塞联合顺铂对比吉西他滨联合顺铂一线治疗中国晚期初治非小细胞肺癌的meta分析  

Pemetrexed plus cisplatin versus gemcitabine plus cisplatin in first-line treatment for China chemotherapy-naive advanced non-small cell lung cancer: A meta-analysis

作　　者：卢佳利 叶自亮 陈晓菊 孙起翔 李超乾 LU Jia-Li;YE Zi-Liang;CHEN Xiao-Ju;SUN Qi-Xiang;LI Chao-Qian(The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Tumor Hospital Affiliated to Guangxi Medical University,Nanning 530021,China;TuJiangbin hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院 [2]广西医科大学附属肿瘤医院 [3]广西壮族自治区江滨医院,广西南宁530021

出　　处：《转化医学电子杂志》2018年第12期11-16,共6页E-Journal of Translational Medicine

基　　金：2016年广西高校中青年教师基础能力提升项目(KY2016YB075)

摘　　要：目的:采用系统评价的方法探讨培美曲塞联合顺铂(PC)对比吉西他滨联合顺铂(GC)治疗中国晚期初治非小细胞肺癌(NSCLC)的临床效果。方法:计算机检索PubMed、web of science、The Cochrane Library、CNKI、VIP、CBM、万方数据库收集PC对比GC一线治疗晚期非小细胞肺癌的随机对照试验(RCT),根据Cochrane评价手册5.0版对纳入进行文献质量评价,采用Revman5.3软件对数据进行meta分析。结果:共纳入8个RCT,共801例患者。Meta分析结果显示PC方案的有效率明显提高(OR=1.28,95%CI:1.10-1.49,P=0.001);但亚组分析结果显示非鳞非小细胞癌组PC方案与GC方案疗效相似(P=0.05,OR=1.52,95%CI:1.00-2.30)。血小板减少的发生率、血红蛋白减少的发生率以及肝功能损害的发生率均显著降低。但两方案之间的疾病控制率、1年生存率、粒细胞减少发生率、恶心/呕吐发生率无显著差异。结论:PC方案一线治疗中国初治非鳞小细胞肺癌有效率与GC方案相当。但本次研究仍存在较多的局限性,两方案对比疗效如何,仍需更多的临床研究证实。Objective:To systematically evaluate the efficiency and safety of pemetrexed plus cisplatin(PC)versus gemcitabine plus cisplatin(PC)in China chemotherapy-naive patients with advanced non-small cell lung cancer(NSCLC).Methods:Randomized controlled trials(RCT)of PC versus GC in first-line treatment for China chemotherapy-naive advanced non-small cell lung cancer were searched in the PubMed,the Cochrane Library,web of science,CNKI VIP,CBM and Wan Fang database.The quality evaluation of included studies was performed according to Cochrane Handbook 5.0 and the meta-analysis was performed by Revman5.3.Results:8 RCTs involving 801 patients were included.The meta-analysis results indicated that the response rate of the PC regimen was significantly higher than those GC regimen(OR=1.28,95%CI:1.10-1.49,P=0.001).But subgroup analysis showed the efficiency of the PC regimen is similar to the GC regimen in nonsquamous non-small cell lung cancer(P=0.05,OR=1.52,95%CI:1.00-2.30).A lower incidence of thrombocytopenia,anemia and hepatic dysfunction were associated with the PC regimen.But the disease control rate,1-year survival rate,neuteopenia rate,nausea/vomlting rate had no significant difference between the two regimens.Conclusion:The efficiency of the PC regimen is similar to the GC regimen in nonsquamous non-small cell lung cancer.But there are still many limitations in this study.More clinical studies are still needed to verify the efficiency of the two regimens.

关 键 词：培美曲塞 吉西他滨 顺铂 非小细胞肺癌 META分析 

分 类 号：R73.4[医药卫生—肿瘤]