DP与GP方案治疗国人晚期非小细胞肺癌疗效meta分析

摘要

Objective:To evaluate the efficacy and toxicity of DP compared with GP in the treatment of Chinese patients with advanced non - small cell lung cancer( NSCLC ). Methods: Relevant randomized controlled trials ( RCTs ) from Pubmed,EMBASE, VIP, CBM and CNKI etc were searched and included until April 30,2011. The quality of these included studies was evaluated by Cochrane Handbook 5. 0, data was analyzed by RevMan 5. 0 software. Results : Seven RCTs involving 685 patients were included. Meta analysis results suggested that compared with GP group , DP group had no significant difference in effective rate( OR = 1. 00 , 95％ CI : 0. 74 - 1. 35 , P = 0. 99 ) , 1 year survival rate( OR = 1. 00 ,95 ％ CI: 0. 74 - 1. 37 ,P = 0. 99 )and leukopenic rate of Ⅲ - Ⅳ degree( OR = 1. 44 , 95％ CI: 1. 00 - 2. 08 ,P = 0. 05 ). Besides, the DP group had a statistically significant benefit in thrombocytopenic rate of Ⅲ - Ⅳ degree( OR = 0. 21 ,95％ CI : 0. 13 - 0. 35 ,P ＜ 0. 00001 ). Conclusion : Compared with DP , GP regimen in Chinese patients with advanced NSCLC had the same effective rate and survival rate , but the thrombocytopenic rate of Ⅲ - Ⅳ degree increased. Platelet count should he carefully monitored in GP chemotherapy regimen of NSCLC.%目的:比较DP与GP方案治疗国人晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效和不良反应.方法:计算机检索pubmed、EMBASE、维普数据库、中国期刊全文数据库、中国生物医学文献数据库、万方数据库等中外文数据库,检索时间至2011年4月30日;同时辅助其它检索,纳入DP与GP方案治疗国人晚期NSCLC的随机对照试验(randomized controlled trials,RCTs),根据Cochrane Handbook 5.0质量评价标准评价,用RevMan 5.0软件进行统计分析.结果:共纳入7篇RCTs(685名研究对象),meta分析结果显示:DP方案与GP方案治疗有效率(OR=1.00,95% CI:0.74-1.35,P=0.99)、1年生存率(OR=1.00,95% CI:0.74-1.37,P=0.99)和III-IV度白细胞减少率(OR=1.44,95% CI:1.00-2.08,P=0.05)无明显差异,但DP方案III-IV度血小板减少率(OR=0.21,95%CI:0.13-0.35,P＜0.00001 )明显低于GP 方案.结论:对于国人晚期NSCLC患者,DP方案与GP方案疗效和1年生存率相当,GP方案III-IV度血小板减少发生率高于DP方案,化疗中要密切监测患者的血小板变化.