紫杉類藥物每周與三周方案比較治療非小細胞肺癌的系統評價_《中國循證醫學雜志》

作者：

1. 蘭州大學循證醫學中心（蘭州 730000）；2. 天津醫科大學總醫院腫瘤科（天津 300052）;

關鍵詞：

紫杉醇多西紫杉醇非小細胞肺癌隨機對照試驗 Meta 分析系統評價

DOI：

10.7507/1672-2531.20100456

視頻：

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目的　系統評價紫杉類藥物每周與三周方案治療非小細胞肺癌的療效和安全性。
方法　檢索1966 ～ 2008 年5 月Cochrane 圖書館、PubMed、EMbase 及CBM 數據庫，搜集紫杉類藥物每周與三周方案組對比治療非小細胞肺癌的隨機對照試驗（RCT）。按Cochrane 手冊4.2.6 RCT 的質量評價標準對納入研究的方法學質量進行評價，并使用RevMan 5.0 軟件進行Meta 分析。
結果　共納入9 個RCT，包括1 438 例患者。每周和三周方案組在1 年生存率［紫杉醇：RR=1.24，95%CI（0.83，1.86）；多西紫杉醇：RR=0.80，95%CI（0.51，1.23）］及總反應率［紫杉醇：RR=1.03，95%CI（0.72，1.49）；多西紫杉醇：RR=0.98 95%CI（0.64，1.49）］方面差異無統計學意義；每周方案組中性粒細胞減少［紫杉醇：RR=0.74，95%CI（0.56，0.97）；多西紫杉醇：RR=0.22，95%CI（0.16，0.30）］較三周組發生率低，但在貧血等其它毒性方面差異無統計學意義。
結論　紫杉類藥物每周及三周方案治療非小細胞肺癌療效相似，每周方案粒細胞減少癥較三周方案發生率低，其它毒性發生率相似。

引用本文： 邵宜,馬力,馬彬,田金徽,楊克虎. 紫杉類藥物每周與三周方案比較治療非小細胞肺癌的系統評價. 中國循證醫學雜志, 2010, 10(5): 602-608. doi: 10.7507/1672-2531.20100456 復制

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6.	Fossella FV, DeVore R, Kerr RN, et al. Randomized phase III trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small-cell lung cancer previously treated with platinumcontaining chemotherapy regimens: The TAX 320 Non-Small Cell Lung Cancer Study Group. J Clin Oncol, 2000, 18(12): 2354-2362.
7.	von Pawel J, Wagner H, Niederle N, et al. Phase II study of paclitaxel and cisplatin in patients with non-small cell lung cancer. Semin Oncol, 1996, 23(6 Suppl 16): 47-50.
8.	Nakamura Y, Kunitoh H, Kubota K, et al. Retrospective analysis of safety and efficacy of low-dose docetaxel 60 mg/m2 in advanced non-small cell lung cancer patients previously treated with platinum- based chemotherapy. Am J Clin Oncol, 2003, 26(5): 459-464.
9.	Seidman AD, Hudis CA, Albanel J, et al. Dose-dense therapy with weekly 1-hour paclitaxel infusions in the treatment of metastatic breast cancer . J Clin Oncol, 1998, 16(10) : 3353-3361.
10.	Lilenbaum RC, Schwartz MA, Seigel L, et al. Phase II trial of weekly docetaxel in second-line therapy for non-small cell lung carcinoma. Cancer, 2001, 92(8): 2158-2163.
11.	Belani CP, Dakhil S, Waterhouse DM, et al. Randomized phase II trial of gemcitabine plus weekly versus three-weekly paclitaxel in previously untreated advanced non-small-cell lung cancer. Ann Oncol, 2007, 18(1): 110-115.
12.	Socinski MA, Ivanova A, Bakri K, et al. A randomized phase II trial comparing every 3-weeks carboplatin/paclitaxel with every 3-weeks carboplatin and weekly paclitaxel in advanced non-small cell lung cancer. Ann Oncol, 2006, 17(1): 104-109.
13.	Camps C, Massuti B, Jiménez A, et al. Randomized phase III study of 3-weekly versus weekly docetaxel in pretreated advanced nonsmall- cell lung cancer: a Spanish Lung Cancer Group trial. Ann Oncol, 2006, 17(3): 467-472.
14.	Chen YM, Shih JF, Perng RP, et al. A randomized trial of different docetaxel schedules in non-small cell lung cancer patients who failed previous platinum-based chemotherapy. Chest, 2006, 129(4): 1031-1038.
15.	Gervais R, Ducolone A, Breton JL, et al. Phase II randomized trial comparing docetaxel given every 3 weeks with weekly schedule as second-line therapy in patients with advanced non-small-cell lung cancer (NSCLC). Ann Oncol, 2005, 16(1): 90-96.
16.	Gridelli C, Gallo C, Di Maio M, et al. A randomised clinical trial of two docetaxel regimens (weekly vs 3 week) in the second-line treatment of non-small-cell lung cancer. The DISTAL01 study. Br J Cancer, 2004, 91(12): 1996-2004.
17.	Lai CL, Tsai CM, Chiu CH, et al. Phase II randomized trial of triweekly versus days 1 and 8 weekly docetaxel as a second-line treatment of advanced non-small cell lung cancer. Jpn J Clin Oncol, 2005, 35(12): 700-706.
18.	Schuette W, Nagel S, Blankenburg T, et al. Phase III study of secondline chemotherapy for advanced non-small-cell lung cancer with weekly compared with 3-weekly docetaxel. J Clin Oncol, 2005, 23(33): 8389-8395.
19.	Lilenbaum R, Rubin M, Samuel J, et al. A randomized phase II trial of two schedules of docetaxel in elderly or poor performance status patients with advanced non-small cell lung cancer. J Thorac Oncol, 2007, 2(4): 306-311.
20.	Massimo DM, Francesco P, Paolo C, et al. Individual patient data meta-analysis of docetaxel administered once every 3 weeks compared with once every week second-line treatment of advanced nonsmall- cell lung cancer. J Clin Oncol, 2007 25(11): 1377-1382.

1. Parkin DM, Bray FI, Devessa SS. Cancer burden for the year 2000: the global picture. Eur J Cancer, 2001, 37(Suppl 8): S4-S66.
2. American Cancer Society: Cancer facts and figures 2008. [2008- 07-20]. http: //www.cancer.org/.
3. Non-small lung cancer Collaborative Group. Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomized clinical trials. BMJ, 1995, 311(7010): 899-909.
4. Noble J, Ellis PM, Mackay JA, et al. Second-line or subsequent systemic therapy for recurrent or progressive non-small cell lung cancer: a systematic review and practice guideline. J Thorac Oncol, 2006, 1(9): 1042-1058.
5. Shepherd FA, Dancey J, Ramlau R, et al. Prospective randomized trial of docetaxel versus best supportive care in patients with nonsmall- cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol, 2000, 18(10): 2095-2103.
6. Fossella FV, DeVore R, Kerr RN, et al. Randomized phase III trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small-cell lung cancer previously treated with platinumcontaining chemotherapy regimens: The TAX 320 Non-Small Cell Lung Cancer Study Group. J Clin Oncol, 2000, 18(12): 2354-2362.
7. von Pawel J, Wagner H, Niederle N, et al. Phase II study of paclitaxel and cisplatin in patients with non-small cell lung cancer. Semin Oncol, 1996, 23(6 Suppl 16): 47-50.
8. Nakamura Y, Kunitoh H, Kubota K, et al. Retrospective analysis of safety and efficacy of low-dose docetaxel 60 mg/m2 in advanced non-small cell lung cancer patients previously treated with platinum- based chemotherapy. Am J Clin Oncol, 2003, 26(5): 459-464.
9. Seidman AD, Hudis CA, Albanel J, et al. Dose-dense therapy with weekly 1-hour paclitaxel infusions in the treatment of metastatic breast cancer . J Clin Oncol, 1998, 16(10) : 3353-3361.
10. Lilenbaum RC, Schwartz MA, Seigel L, et al. Phase II trial of weekly docetaxel in second-line therapy for non-small cell lung carcinoma. Cancer, 2001, 92(8): 2158-2163.
11. Belani CP, Dakhil S, Waterhouse DM, et al. Randomized phase II trial of gemcitabine plus weekly versus three-weekly paclitaxel in previously untreated advanced non-small-cell lung cancer. Ann Oncol, 2007, 18(1): 110-115.
12. Socinski MA, Ivanova A, Bakri K, et al. A randomized phase II trial comparing every 3-weeks carboplatin/paclitaxel with every 3-weeks carboplatin and weekly paclitaxel in advanced non-small cell lung cancer. Ann Oncol, 2006, 17(1): 104-109.
13. Camps C, Massuti B, Jiménez A, et al. Randomized phase III study of 3-weekly versus weekly docetaxel in pretreated advanced nonsmall- cell lung cancer: a Spanish Lung Cancer Group trial. Ann Oncol, 2006, 17(3): 467-472.
14. Chen YM, Shih JF, Perng RP, et al. A randomized trial of different docetaxel schedules in non-small cell lung cancer patients who failed previous platinum-based chemotherapy. Chest, 2006, 129(4): 1031-1038.
15. Gervais R, Ducolone A, Breton JL, et al. Phase II randomized trial comparing docetaxel given every 3 weeks with weekly schedule as second-line therapy in patients with advanced non-small-cell lung cancer (NSCLC). Ann Oncol, 2005, 16(1): 90-96.
16. Gridelli C, Gallo C, Di Maio M, et al. A randomised clinical trial of two docetaxel regimens (weekly vs 3 week) in the second-line treatment of non-small-cell lung cancer. The DISTAL01 study. Br J Cancer, 2004, 91(12): 1996-2004.
17. Lai CL, Tsai CM, Chiu CH, et al. Phase II randomized trial of triweekly versus days 1 and 8 weekly docetaxel as a second-line treatment of advanced non-small cell lung cancer. Jpn J Clin Oncol, 2005, 35(12): 700-706.
18. Schuette W, Nagel S, Blankenburg T, et al. Phase III study of secondline chemotherapy for advanced non-small-cell lung cancer with weekly compared with 3-weekly docetaxel. J Clin Oncol, 2005, 23(33): 8389-8395.
19. Lilenbaum R, Rubin M, Samuel J, et al. A randomized phase II trial of two schedules of docetaxel in elderly or poor performance status patients with advanced non-small cell lung cancer. J Thorac Oncol, 2007, 2(4): 306-311.
20. Massimo DM, Francesco P, Paolo C, et al. Individual patient data meta-analysis of docetaxel administered once every 3 weeks compared with once every week second-line treatment of advanced nonsmall- cell lung cancer. J Clin Oncol, 2007 25(11): 1377-1382.

《中國循證醫學雜志》

紫杉類藥物每周與三周方案比較治療非小細胞肺癌的系統評價

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《中國循證醫學雜志》

紫杉類藥物每周與三周方案比較治療非小細胞肺癌的系統評價

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