紫杉烷类药物2周对比3周化疗方案治疗进展期非小细胞肺癌的系统评价

Bi-weekly versus tri-weekly chemotherapy regimens of Taxanes for advanced non-small cell lung cancer：a systematic review

摘要:

目的：系统评价紫杉烷类药物2周与3周化疗方案治疗进展期非小细胞肺癌（Non-small cell lung cancer，NSCLC）的疗效和安全性。方法：检索数据库PubMed、Embase、Cochrane Library、Web of Science，维普、万方、CNKI，检索时间从各数据库建库至2011年7月25日，搜集紫杉烷类药物2周对比3周化疗方案治疗NSCLC的随机对照试验（Randomized controlled trials，RCTs）。选择符合纳入标准的文献，提取资料、按照Cochrane协作网推荐的质量评价标准进行文献质量评价。使用RevMan 5.0 软件进行统计学分析。结果：共纳入8个RCTs，包括624例患者。Meta分析结果显示：与3周组相比，2周组可以降低白细胞减少（RR=0.49，95％CI：0.38-0.62，P＜0.01）、恶心/呕吐（RR=0.60，95％CI：0.44-0.81，P＜0.01）、脱发（RR=0.35，95％CI：0.16-0.77，P＜0.05）等毒副反应的发生率；但在有效率（RR=1.09，95％CI：0.88-1.35，P=0.44）、1年生存率（RR=1.16，95％CI：0.91-1.47，P=0.22）和肝毒性（RR=0.26，95％CI：0.04-1.56，P=0.14）方面的差异无统计学意义。结论：紫杉烷类药物2周与3周化疗方案治疗进展期NSCLC的有效性和1年生存率相似，但2周化疗方案毒副反应的发生率较低。

Abstract:

Objective：To evaluate the effectiveness and safety of bi-weekly versus tri-weekly chemotherary regimens of Taxanes for non-small cell lung cancer（NSCLC）. Methods：Relevant randomized controlled trials（RCTs） of bi-weekly versus tri-weekly chemotherapy regimens of Taxanes for NSCLC from databases of PubMed，Embase，Cochrane Library，Web of Scinece，VIP，Wanfan－data and CNKI were searched. The retrieval time was from the building time of each database to July 25，2011. The articles fit the in－clusion criteria were selected and the information in the articles was extracted. The quality of these included studies in accordance with the quality evaluation criteria recommended by the Cochrane Collaboration was evaluated and then analyzed statistically by RevMan 5.0 software. Results：Eight RCTs and 624 patients were included. Meta analysis results suggested that the bi-weekly regi－men was more effective in decreasing the incidences of leukopenia（RR=0.49，95％CI：0.38-0.62，P＜0.01），nausea and vomiting（RR=0.60，95％CI：0.44-0.81，P＜0.01） and alopecia（RR=0.35，95％CI：0.16-0.77，P＜0.05） than tri-weekly regimen. There was no statisti－cal difference between bi-weekly regimen and tri-weekly regimen in effective rate（RR=1.09，95％CI：0.88-1.35，P=0.44）、1-year sur－vival rate（RR=1.16，95％CI：0.91-1.47，P=0.22） and liver toxicity（RR=0.26，95％CI：0.04-1.56，P=0.14）. Conclusions：The effec－tive rate and 1-year survival rate are similar between the two chemotherary regimens，but toxicity incidence of bi-weekly chemother－ary regimen is lower than that of tri-weekly chemotherary regimen.