摘要
目的评价重组人血管内皮抑制素联合长春瑞滨+顺铂方案(NPE)治疗晚期非小细胞肺癌(NSCLC的疗效和安全性。方法使用计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、ClinicalTrials、中国知网、万方数据库及维普等数据平台,检索时间为自建库至2020年9月,收集NPE与长春瑞滨+顺铂方案(NP)方案治疗晚期NSCLC的随机对照试验(RCTs),由两名研究者独立提取文献信息及评价纳入研究偏倚,采用RevMan5.3.0软件进行Meta分析。结果共纳入23项前瞻性临床研究,合计1 806例晚期NSCLC患者;Meta分析结果显示,NPE方案治疗晚期NSCLC的客观有效率(RR=1.76,95%CI:1.53~2.02,P<0.000 01)、临床受益率RR=1.21,95%CI:1.14~1.28,P<0.000 01)以及治疗前后血清癌胚抗原(carcinoembryonic antigen,CEA)水平下降程度(MD=7.65,95%CI:3.17~12.12,P=0.000 8)均高于NP方案;两方案在白细胞下降、血小板下降、胃肠道反应、肝功能损害的不良反应方面比较差异均无统计学意义(P>0.05),但是,NPE方案的心脏毒性发生风险高于NP方案(RR=2.52,95%CI:1.44~4.43,P=0.001)。结论与晚期NSCLC患者的NP治疗方案相比,NPE方案能提高治疗的客观有效率和临床受益率,且不良反应可耐受,值得进一步临床应用。
Objective To evaluate the efficacy and safety of rh-Endostatin plus the combination of vinorelbine and cisplatin(NPE)in the treatment of advanced non-small cell lung cancer(NSCLC).Methods Data platforms such as PubMed,EMbase,The Cochrane Library,Web of Science,ClinicalTrials,CNKI,WANFANG DATA and VIP were retrieved by computer to collect randomized controlled trials(RCTs)on NPE regimen for advanced NSCLC from inception to September 2020.Meta-analysis was performed using RevMan 5.3.0 software after two investigators independently extracted the data and assessed the risk of bias in the included studies.Results A total of 23 trials with 1806 patients with advanced NSCLC were included.Meta-analysis results suggested that objective response rate(ORR),clinical benefit rate(CBR),and decrease of carcinoembryonic antigen(CEA)after treatment in the NPE group were significantly higher than that in the NP group,respectively:ORR,RR=1.76,95%CI 1.53—2.02,P<0.00001;CBR,RR=1.21,95%CI 1.14—1.28,P<0.00001;decrease of CEA,MD=7.65,95%CI:3.17—12.12,P=0.0008.There were no significant difference between the two groups in adverse reactions,such as leukopenia,thrombocytopenia,nausea and vomiting,and damage in liver(P>0.05).Risk of cardiotoxicity was higher in the NPE group than in the NP group(RR=2.52,95%CI 1.44—4.43,P=0.001).Conclusion Compared with NP chemotherapy,NPE chemotherapy can improve the rates of response and the clinical benefit with tolerable adverse effects,which is worthy of further clinical application.
作者
蔡秋燕
王静
曾桂星
罗玉玲
刘升明
陈丽
CAI Qiu-yan;WANG Jing;ZENG Gui-xing;LUO Yu-ling;LIU Sheng-ming;CHEN Li(Department of Respiratory and Critical Care,the First Affiliated Hospital of Jinan University,Guangzhou 510630,Guangdong,CHINA)
出处
《海南医学》
CAS
2021年第4期526-532,共7页
Hainan Medical Journal
基金
暨南大学科研培育与创新基金跃升计划项目(编号:21617491)。
