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目的:系统评价吉西他滨联合多西他赛治疗非小细胞肺癌(NSCLC)的疗效和安全性,为临床提供循证参考。方法:计算机检索PubMed、Cochrane图书馆、Elsevier数据库、中国期刊全文数据库、万方数据库和中文科技期刊数据库,收集吉西他滨联合多西他赛(试验组)对比第三代化疗药联合顺铂(对照组)治疗NSCLC疗效和安全性的随机对照试验(RCT),对符合纳入标准的临床研究提取资料,并采用改良的Jadad量表进行质量评价后,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入9项RCT,合计1 986例患者。Meta分析结果显示,两组患者总有效率[RR=0.93,95%CI(0.83,1.05),P=0.27]、1年生存率[RR=0.97,95%CI(0.87,1.09),P=0.64]、肝功能损害发生率[RR=0.35,95%CI(0.06,2.18),P=0.26]、白细胞减少发生率[RR=0.80,95%CI(0.57,1.10),P=0.17]、血红蛋白下降率[RR=0.65,95%CI(0.25,1.69),P=0.38]比较差异均无统计学意义;试验组患者肾功能损害发生率[RR=0.09,95%CI(0.02,0.38),P=0.001]、神经毒性发生率[RR=0.51,95%CI(0.28,0.94),P=0.03]显著低于对照组,而肺损伤发生率[RR=8.71,95%CI(2.04,37.12),P=0.003]显著高于对照组,差异均有统计学意义。结论: 吉西他滨联合多西他赛治疗NSCLC的疗效与第三代化疗药联合顺铂相当,但其对患者肾功能及神经系统的损害更小而肺毒性较大。
OBJECTIVE: To systematically review the efficacy and safety of gemcitabine combined with docetaxel in the treatment of non-small cell lung cancer (NSCLC), and provide evidence-based reference for clinical treatment. METHODS: Retrieved from PubMed, Cochrane Library, Elsevier, CJFD, Wangfang Database and VIP, randomized controlled trials (RCT) about the efficacy and safety of gemcitabine combined with docetaxel (test group) versus the 3rd generation chemotherapeutic agents combined with cisplatin (control group) in the treatment of NSCLC were collected. Meta-analysis was performed by using Rev Man 5.3 software after quality evaluation by modified Jadad scale. RESULTS: Totally 9 RCTs were included, involving 1 986 patients. Results of Meta-analysis showed, there were no significant differences in the total effective rate [RR=0.93,95%CI(0.83,1.05),P=0.27],1-year survival rate [RR=0.97,95%CI(0.87,1.09),P=0.64], the incidences of liver dysfunction [RR=0.35,95%CI(0.06,2.18),P=0.26] and leukopenia [RR=0.80,95%CI(0.57,1.10),P=0.17] and decreased rate of hemoglobin [RR=0.65, 95%CI(0.25,1.69),P=0.38] in 2 groups; the incidences of liver dysfunction [RR=0.09, 95%CI(0.02, 0.38),P=0.001] and neurotoxicity in test group were significantly lower than control group, while the incidence of lung injury [RR=8.71, 95%CI(2.04,37.12),P=0.003] was significantly higher than control group, the differences were statistically significant. CONCLUSIONS: Gemcitabine combined with docetaxel shows similar efficacy to the 3rd generation chemotherapeutic agents combined with cisplatin in the treatment of NSCLC, less effect on renal function and nerve while high on pulmonary toxicity.
吉西他滨多西他赛非小细胞肺癌顺铂Meta分析随机对照试验
GemcitabinDocetexalnon-small cell lung cancerCisplatinMeta-analysisRandomized controlled trial
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