伊立替康或依托泊苷联合铂类药物一线治疗广泛期小细胞肺癌的meta分析∗

摘要

Objective To assess the efficacy and safety of irinotecan plus platinum(IP) compared with etoposide plus plati⁃num(EP) regimens in patients with extensive small cell lung cancer(ED⁃SCLC). Methods We searched the Cochrane Library, Pubmed, Medline, CBM,CNKI,CBM and WanFang databases to collect the randomized controlled trials,in which IP regimen was com⁃pared with EP regimen as the first⁃line treatment of ED⁃SCLC published before May 2014. RevMan 5�2 software was used for meta⁃a⁃nalysis. Results Nine studies involving 2229 patients were included. The result of meta⁃analysis showed that in patients with ED⁃SCLC, IP regimen was better than EP regimen in one⁃year survival rate( OR=1�32, 95%CI:1�10~1�58, P=0�003) and there was no significant difference between the both groups in the effective rate(OR=1�13, 95%CI:0�90~1�41, P=0�29). In the aspect of safety, the major adverse event for IP was more digestive toxicities, whereas EP was associated with more hematologic toxicities. Con⁃clusion IP regimen shows more superiority and can be used as the first⁃line drug for ED⁃SCLC, who intoleranced to hematologic toxci⁃ties.%目的：评价伊立替康联合铂类（IP）方案对比依托泊苷联合铂类（EP）方案治疗广泛期小细胞肺癌（ED⁃SCLC）的疗效及安全性。方法计算机检索Cochrane Library、Pubmed、Medline、CBM、中国期刊全文数据库（ CNKI）、中国生物医学文献数据库（ CBM）及万方数据库，纳入IP方案与EP方案治疗ED⁃SCLC的随机对照试验，检索时间截止于2014年5月，由2名评价者按照纳入和排除标准独立选择文献、提取资料并评价质量。采用RevMan 5�2软件进行Meta分析。结果最终纳入9项研究，共2229例ED⁃SCLC患者。与EP方案比较，IP方案治疗的1年生存率较高（ OR＝1�32，95％CI：1�10～1�58，P＝0�003）；两种方案客观有效率的差异无统计学意义（ OR＝1�13，95％CI：0�90～1�41，P＝0�29）；在安全性方面，IP方案主要为消化道毒性；EP方案主要为血液学毒性。结论与EP方案相比，IP方案可能适合于不能耐受血液毒性的ED⁃SCLC患者。