摘要
背景与目的非小细胞肺癌(non-small cell lung cancer,NSCLC)是恶性程度和死亡率极高的肿瘤,吉非替尼是近年来研发的一种新的分子靶向药物,本文旨在系统评价吉非替尼治疗NSCLC的有效性和安全性。方法计算机检索Cochrane图书馆(2010年第8期)、PubMed、Embase、CNKI、VIP,中华医学会数字化期刊(截至2010年8月)。两名评价者独立评价纳入研究的质量、提取资料并交叉核对,同质研究采用RevMan5.0软件进行meta分析。结果共纳入13个随机对照试验,包括6,207例病例。Meta分析结果显示吉非替尼相比较于安慰剂、多西紫杉醇、顺铂+多西紫杉醇、培美曲赛等治疗方案而言,中位生存时间、1年生存率、完全缓解率、部分缓解率、疾病无进展率等方面未显示出优势。与多西紫杉醇、顺铂+多西紫杉醇相比,吉非替尼可明显增加化疗患者的总有效率(RR=1.41,95%CI:1.10-1.80;RR=1.93,95%CI:1.26-2.94)。吉非替尼对比安慰剂、多西紫杉醇能够提高患者的生存质量和总FACT-L改善率(RR=1.42,95%CI:1.16-1.74;RR=1.66,95%CI:1.39-1.97)。吉非替尼的主要不良反应包括皮疹/痤疮、皮肤干燥、腹泻,其血液毒性较低。结论吉非替尼治疗NSCLC有一定的优势,可作为治疗NSCLC的常规药物。
Background and objective Malignant grade and death rate are very high for non-small cell lung cancer,and gefitinib is a new molecule target anticancer drug. The aim of this meta analysis is to evaluate the clinical ef？cacy and safety of gefitinib for non-small cell lung cancer. Methods We searched the Cochrane Central Register of Controlled Trials（CEN-TRAL） （The Cochrane Library,Issue 8,2010） ,PubMed（1966-2010.8） ,EMBASE（1974-2010.8） ,CNKI（1994-2010.8） ,VIP（1989-2010.8） ,and CMD Digital Periodicals（1998-2010.8） . Two reviewers independently evaluated the quality of the included studies and extracted the data. Meta-analyses were performed by RevMan 5.0 software. Results Thirteen randomized controlled trials（RCTs） involving 6,207 patients were included. The results of meta-analyses showed that： gefitinib showed no remarkable advantage in media survival time,1 year survival rate,complete response rate（CRR） ,partial response rate（PRR） ,stable disease（SD） when compared to Placebo,Docetaxel,Cisplatin＋Docetaxel,Pemetrexed. Gifitinib could increase overall survival rate compared to Docetaxel,Cisplatin＋Docetaxel（RR=1.41,95%CI： 1.10-1.80;RR=1.93,95%： 1.26-2.94） . When compared to Placebo,Docetaxel,gifitinib could improve life quality of Total-FACT-L improve rate（RR=1.42,95%CI： 1.16-1.74;RR=1.66,95%CI： 1.39-1.97） . The major adverse event for gifitinib were rash/acne,dry skin,diarrhea. While gifitinib showed lower hematology toxicity. Conclusion Gifitinib shows more superiority for non-small cell lung cancer,and its clinical appli-cation is worthy to be advocated.
出处
《中国肺癌杂志》
CAS
2011年第4期351-357,共7页
Chinese Journal of Lung Cancer
基金
兰州大学2010教学研究项目(No.201022)和兰州大学循证医学中心“循证医学创新项目”(No.2010LDEBM-B)资助~~
