恩度联合含铂类化疗药物治疗晚期非小细胞肺癌的疗效及安全性的Meta分析

A Meta analysis of endostar（rh-endostain，YH-16） plus chemotherapy containing platinum in the treatment of advanced non-small cell lung cancer

摘要:

目的：本文旨在用Meta分析观察恩度联合含铂类化疗药物治疗晚期非小细胞肺癌（Non-small cell lung cancer，NSCLC）的近期疗效及其安全性，并与单纯含铂类化疗药物治疗方案疗效及其安全性进行比较。方法：采用Cochrane系统评价方法，计算机检索维普期刊中文数据库、万方数据库、中国生物医学文献数据库、中国知网数据库、PubMed等，并辅以手工检索其他来源文献，符合入选标准的文献由4名评价者依据Jadad量表独立评价并交叉核对纳入研究的质量，采用RevMan4.2软件进行Meta分析。结果：11篇文献（共1 012例患者）被纳入Meta分析，结果显示恩度联合含铂类药物化疗方案与单纯使用含铂类药物化疗方案治疗晚期NSCLC的总有效率（RR=1.89，95%CI：1.55-2.29，P<0.000 01）和临床受益率（RR=1.21，95%CI：1.12-1.30，P<0.000 01）的差异有统计学意义，且恩度联合化疗组的不良反应中白细胞减少、恶心呕吐、肝功能损害、肾功能损害、脱发的发生率与单纯化疗组相比差异无统计学意义，心律失常与单纯化疗组相比差异有统计学意义。结论：恩度联合含铂类药物化疗方案与单纯使用含铂类药物化疗方案相比治疗晚期NSCLC能提高总有效率和临床受益率，没有显著提高不良反应的发生率。

Abstract:

Objective：To use Meta analysis to evaluate the short term efficacy and safety of endostar plus chemotherapy in the treat－ment of advanced NSCLC，and to compare it with the chemotherapy containing platinum alone. Methods：Cochrane systematic evalu－ation was used to search literatures from VIP，CBM，WanFang Data，PubMed，CNKI，etc. on Internet.Literatures from other sources were also searched by hand. The literature quality was independently evaluated and cross-checked by four evaluators according to the Jadad scale，and the results of homogeneous studies were analysed with RevMan4.2 software. Results：11 literatures（1 012 cases） were selected to the Meta analysis，and the analysis suggested that compared to the chemotherapy containing platinum alone，the combina－tion with endostar had a statistically significant benefit in OR（overall response rate）（RR=1.89，95%CI：1.55-2.29，P<0.000 01） and CBR（clinical benefit rate）（RR=1.21，95%CI：1.12-1.30，P<0.000 01）.The combination had no statistically significant benefit in leukopenia，nausea and vomiting，liver function，kidney function and alopecia，but had statistically significant benefit in arrhythmia. Conclusion：Compared to the chemotherapy containing platinum alone，endostar plus the chemotherapy can improve OR and CBR in the treatment for the advanced non-small cell lung cancer（NSCLC）. The combination has not increased the incidence rate of ad－verse events significantly.