摘要
目的系统评价奈达铂联合化疗与顺铂联合化疗比较治疗晚期非小细胞肺癌的有效性和安全性。方法计算机检索Cochrane Library、PubMed、EMbase、CBM、VIP和WanFang Data数据库,检索时限均为建库至2012年1月,收集关于奈达铂联合化疗与顺铂联合化疗比较治疗晚期非小细胞肺癌的随机对照试验(RCT)。由两位研究者按照纳入与排除标准筛选文献、提取资料和评价质量后,采用RevMan 5.0软件进行Meta分析。结果共纳入15个RCT,1 076例患者。Meta分析结果显示:与顺铂联合化疗比较,奈达铂联合化疗能降低恶心呕吐[RR=0.56,95%CI(0.48,0.65),P<0.000 01]、肾功能损伤[RR=0.47,95%CI(0.30,0.74),P=0.001]的风险,但会增加血小板减少的风险[RR=1.59,95%CI(1.20,2.11),P=0.001]。在客观缓解率[RR=1.09,95%CI(0.92,1.29),P=0.03]、白细胞减少[RR=1.05,95%CI(0.92,1.19),P=0.50]及血红蛋白减少[RR=0.92,95%CI(0.80,1.07),P=0.30]方面,两组差异均无统计学意义。结论奈达铂联合化疗与顺铂联合化疗比较治疗晚期非小细胞肺癌,奈达铂联合化疗能显著降低恶心呕吐以及肾功能损伤发生的风险,但两组客观缓解率相当,奈达铂联合化疗发生血小板减少的风险更高。受纳入研究质量限制和可能存在的发表偏倚影响,上述结论尚需更多高质量的随机对照试验加以验证。
Objective To evaluate the effectiveness and safety of nedaplatin combined with chemotherapy versus cisplatin combined with chemotherapy for advanced non-small cell lung cancer （NSCLC）. Methods the randomized controlled trials （RCTs） on nedaplatin combined with chemotherapy versus cisplatin combined with chemotherapy for advanced NSCLC were searched in The Cochrane Library, PubMed, EMbase, CBM, VIP and WanFang Data from the date of their establishment to January 2012. According to the inclusion and exclusion criteria, two reviewers independently screened the studies, extracted the data and assessed the quality. Then RevMan 5.0 software was used for meta-analysis. Results A total of 15 RCTs involving 1 076 patients were included. The results of meta-analysis showed that, compared with the cisplatin combined with chemotherapy, nedaplatin combined with chemotherapy could reduce the risks of nausea and vomiting （RR=0.56, 95%CI 0.48 to 0.65, P〈0.000 01）, decrease the risk of renal function impairment （RR=0.47, 95%CI 0.30 to 0.74, P=0.001）, but increase the risk of thrombocytopenia （RR= 1.59, 95%CI 1.20 to 2.11, P=0.001）. There were no significant differences between the two groups in obiective response rate （ORR） （RR=I.09, 95%CI 0.92 to 1.29, P=0.03）, leukopenia （RR=I.05, 95%CI 0.92 to 1.19, P--0.50）, and hemoglobin reduction （RR=0.92, 95%CI 0.80 to 1.07, P=0.30）. Condusion Compared with cisplatin combined with chemotherapy for advanced NSCLC patients, nedaplatin in combination with chemotherapy can significantly reduce the risks of nausea, vomiting and renal function impairment. Although the ORRs are similar in the two groups, nedaplatin combined with chemotherapy can cause a higher risk of thrombocytopenia. For the quality restriction and possible publication bias of the included studies, more high quality RCTs are required to further verify this conclusion.
出处
《中国循证医学杂志》
CSCD
2013年第1期47-54,共8页
Chinese Journal of Evidence-based Medicine
关键词
奈达铂
顺铂
非小细胞肺癌
META分析
系统评价
随机对照试验
Nedaplatin
Cisplatin
Non-small cell lung cancer
Meta-analysis
Systematic review
Randomized con trolled trial
