Comparison of irinotecan/carboplatin versus etoposide/carboplatin for extended disease small cell lung cancer(ED-SCLC):A systematic review and meta-analysis of randomized controlled trials  

作　　者：Zeeshan Afzal Sara Hira Xia Song Na Wang 

机构地区：[1]Department of Internal Medicine,Shanxi Medical University,Taiyuan,Shanxi,China [2]FMH College of Medicine&Dentistry,Lahore,Punjab,Pakistan [3]Department of Respiratory Medicine,Shanxi Provincial Cancer Hospital,Taiyuan,Shanxi,China

出　　处：《Malignancy Spectrum》2024年第4期300-311,共12页肿瘤学全景(英文)

摘　　要：Background:Platinum-based chemotherapy in addition to the nonplatinum agent etoposide is the standard of care for extensive-stage small cell lung cancer(ES-SCLC).However,the front-line chemotherapy regimen is not known.Therefore,we aimed to perform this review comparing irinotecan/carboplatin(IC)and etoposide/carboplatin(EC)in patients of extended disease small cell lung cancer(ED-SCLC).Methods:We searched three databases,that is,PubMed,Embase,and Cochrane Library.The outcomes for complete response(CR),median overall survival(OS),and progression-free survival(PFS)were evaluated.In addition,adverse events such as leukopenia,thrombocytopenia,anemia,diarrhea,and infections were also assessed.RevMan 5.4.1 was used to perform the statistical analysis.Results:Three randomized controlled trials(RCTs)with 676 patients were included.There was a significant difference between IC and EC arms in terms of CR(risk ratio[RR]=2.52;95%confidence interval[CI]:1.20−5.32;p=0.02,I^(2)(i.e.,the percentage of the total variance that is due to betweenstudy heterogeneity)=0%),leukopenia(RR=0.47;95%CI:0.23−0.97;p=0.04;I^(2)=90%),amimia(RR=0.55;95%CI:0.38−0.78;p=0.0008;I^(2)=0%),thrombocytopenia(RR=0.51;95%CI:0.39–0.68;p=0.00001;I^(2)=0%),and diarrhea(RR=4.88;95%CI:1.64−14.49;p=0.004;I^(2)=33%).There was no statistically significant difference between IC and EC arms in terms of median OS(hazard ratio[HR]=1.16;95%CI:0.84−1.62;p=0.37;I^(2)=74%),PFS(HR=1.04;95%CI:0.69−1.56;p=0.85;I^(2)=77%),nausea(RR=1.70;95%CI:0.76−3.81;p=0.19;I^(2)=0%),infection(RR=0.97;95%CI:0.64−1.48;p=0.89;I^(2)=0%),and treatment-related deaths(RR=0.58;95%CI:0.24−1.42;p=0.23;I^(2)=0%).Conclusion:This meta-analysis provides valuable evidence supporting the superiority of IC regimens over EC regimens in terms of CR and toxicity profile for ED-SCLC.

关 键 词：CARBOPLATIN ED-SCLC ETOPOSIDE IRINOTECAN small cell lung cancer 

分 类 号：R734.2[医药卫生—肿瘤]