吉西他滨联合顺铂方案与多西紫杉醇联合顺铂方案治疗晚期非小细胞肺癌的系统评价.docVIP

吉西他滨联合顺铂方案与多西紫杉醇联合顺铂方案治疗晚期非小细胞肺癌的系统评价 方 向1 ，胡世莲,2 ，沈 干2 ，吴 蕾2,3 ，陈 尹2 ，孙玉蓓4 ，徐婷娟2 ，徐维平2 （230001合肥省立医院1，神经内科3，肿瘤科4 ；230001合肥安徽省循证医学中心. [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[RR1.02，95%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3~4级血小板减少、贫血、恶心呕吐发生率高于DP方案[OR7.68，95%CI(3.91，15.08)；OR2.02，95%CI(1.39，2.92)；OR1.39，95%CI(1.05，1.85)]；GP方案3~4级白细胞减少及腹泻发生率低于DP方案[OR0.63，95%CI(0.46，0.86)；OR0.27，95%CI(0.13，0.58)]；两方案的3~4级中性粒细胞减少、虚弱乏力的差异没有统计学意义(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。 [关键词] 晚期非小细胞肺癌；化学治疗；吉西他滨；多西紫杉醇；系统评价 Gemcitabine versus Docetaxel in Combination with Cisplatin for Advanced Non Small Cell Lung Cancer：A Systematic Review 1, Hu Shi-lian1, 2, Shen Gan2, Chen Yin2, Wu Lei2,3, Sun Yubei4, Xu Tingjuan2, Xu Weiping2 1. Department of Geriatrics, the Affiliated Anhui Provincial Hospital of Anhui Medical University, Hefei 230001, China; 2Anhui Evidence-based Medicine Center, Hefei 230001, China; 3. Department of Neurology, the Affiliated Anhui Provincial Hospital of Anhui Medical University, Hefei 230001, China; 4. Department of Oncology, the Affiliated Anhui Provincial Hospital of Anhui Medical University, Hefei 230001, China [Abstract] Objective To compare and evaluate the effectiveness and safety of gemcitabine versus docetaxel in combination with cisplatin for patients with advanced non small cell lung cancer(NSCLC). Methods We searched COCHRANE, PUBMED, CBM, CNKI WANFANG etc to collect randomized controlled trials in which gemcitabine versus docetaxel plus cisplatin for patients with advanced non small cell lung cancer was compared. Two reviewers evaluated the quality of included trials independently. The Cochrane Collaboration’s software RevMan 5.0 was used for meta-analyses. Results Sixteen studies involvi