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背景与目的晚期非小细胞肺癌患者是否可以从厄洛替尼治疗中获益尚不确定,本文拟系统评价厄洛替尼治疗晚期非小细胞肺癌的有效性及安全性。方法计算机检索VIP、CBM、CNKI、PubMed、EMBASE、The Cochrane Library等数据库,同时追查纳入文献的参考文献并且联系本领域专家、通讯作者,以获取以上检索尚未发现的相关信息。按纳入排除标准纳入厄洛替尼治疗晚期非小细胞肺癌的随机对照试验并对其进行质量评价,采用Cochrane协作网提供RevMan 5.0统计软件进行meta分析。结果共纳入3个随机对照试验(2969名病例),meta分析结果表明,与安慰剂相比,厄洛替尼可提高患者1年生存率(OR=1.18,95%CI:1.01-1.38)和肿瘤反应率(OR=1.24,95%CI:1.03-1.49),延长中位生存期、疾病无进展期、肿瘤反应持续时间,同时增加3-4级皮疹(OR=16.33,95%CI:7.01-38.02)和腹泻(OR=5.02,95%CI:2.93-8.60)的发生率。结论晚期非小细胞肺癌患者可以从厄洛替尼治疗中获益,但皮疹发生率和腹泻发生率明显增加,而在血液系统损害、严重肝肾损害、心脏毒性等方面与安慰剂没有差异。
BACKGROUND & OBJECTIVE It is uncertain whether patients with advanced non-small cell lung cancer can benefit from erlotinib treatment. In this paper, the efficacy and safety of erlotinib in the treatment of advanced non-small cell lung cancer were systematically evaluated. Methods The databases of VIP, CBM, CNKI, PubMed, EMBASE and The Cochrane Library were searched by computer, and the references included in the literature were traced simultaneously, and relevant experts in the field and correspondents were contacted for relevant information not found in the above search. Randomized controlled trials of erlotinib for the treatment of advanced non-small cell lung cancer were included in the exclusion criteria and their quality evaluated. The Cochrane Collaboration was used to provide RevMan 5.0 statistical software for meta-analysis. Results A total of 3 randomized controlled trials (2,969 cases) were included. Meta-analysis showed that erlotinib increased 1-year survival (OR = 1.18, 95% CI: 1.01-1.38) and placebo Tumor response rate (OR = 1.24, 95% CI: 1.03-1.49) prolonged median survival, disease progression, duration of tumor response, and grade 3-4 rash (OR = 16.33, 95% CI: 7.01 -38.02) and diarrhea (OR = 5.02, 95% CI: 2.93-8.60). Conclusions Patients with advanced non-small cell lung cancer may benefit from erlotinib treatment. However, the incidence of rash and the incidence of diarrhea are significantly increased. However, there is no difference between the two groups in terms of blood system damage, severe liver and kidney damage, and cardiotoxicity.