摘要
目的比较吉西他滨联合顺铂方案（GP）与多西紫杉醇联合顺铂方案（DP）治疗晚期非小细胞肺癌的临床疗效和安全性。方法计算机检索Cochrane图书馆（2010年第1期）、Pubmed、CBM、CNKI、万方等数据库;纳入随机对照试验,采用Cochrane系统评价方法进行评价。结果共纳入16个研究1670例晚期非小细胞肺癌患者,16个研究均未详细报道是否采用盲法。DP方案显示出与GP方案相当的中位生存期、中位疾病进展时间、有效率[RR=1.02,95%CI（0.89,1.15）]和生存率[1年RR=1.07,95%CI（0.93,1.24）;2年RR=1.02,95%CI（0.66,1.58）]。15个研究的3~4级毒副作用合并结果显示,GP方案血小板减少、贫血、恶心呕吐发生率高于DP方案[RR=5.22,95%CI（2.97,9.18）;RR=1.76,95%CI（1.30,2.38）;RR=1.29,95%CI（1.04,1.60）];GP方案白细胞减少及腹泻发生率低于DP方案[RR=0.71,95%CI（0.56,0.89）;RR=0.30,95%CI（0.15,0.60）];两方案中性粒细胞减少、虚弱乏力的差异无统计学意义（P〉0.05）。结论在两方案疗效相近的情况下,选择GP方案或DP方案将取决于药物的毒性及患者的耐受性。
Objective To compare the effect and safety of gemcitabine（GP）or docetaxel（DP）in combination with cisplatin for advanced non-small cell lung cancer（NSCLC）.Methods Randomized controlled trials were searched from the Cochrane Library（first issue in 2010）,PubMed,CBM,CNKI,and Wanfang databases and evaluated using the Cochrane Collaboration＇s software RevMan 5.0.Results Sixteen studies involving 1670 patients with NSCLC were included in this study.The blinding method was not reported in these studies.The median survival time,median disease progression time,effective rate（RR=1.02,95%CI=0.89 and 1.15）,and 1-and 2-year survival rates（RR=1.07,95%CI=0.93 and 1.24;RR=1.02,95%CI=0.66 and 1.58）of patients with NSCLC were similar for the DP or GP in combination with cisplatin.The incidence of severe（3 to 4 grade）thrombocytopenia（RR=5.22,95%CI=2.97 and 9.18）,anemia（RR=1.76,95%CI=1.30 and 2.38）,nausea and vomiting（RR=1.29,95%CI=1.04 and 1.60）was higher in combined GP and cisplatin regimen than in combined DP and cisplatin regimen,while the incidence of severe leukocytopenia（RR=0.71,95%CI=0.56 and 0.89）and diarrhea（RR=0.30,95%CI=0.15 and 0.60）was lower in combined GP and cisplatin regimen than in combined DP and cisplatin regimen.Conclusion The effect of the two regimens is similar for advanced NSCLC.The selection of them depends on the toxicity of drugs used and the tolerance of patients.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2010年第21期2347-2351,共5页
Journal of Third Military Medical University
