培美曲塞與多西紫杉醇比較治療晚期非小細胞肺癌的Meta分析_《中國循證醫學雜志》

作者：

姜金 ^1,2 , 王曉晶 ^1,2 , 張璐 ^1,2 , 林喬 ^1,2 , 陳淼 ^1,2 ,  田金徽 ¹

1. 蘭州大學循證醫學中心，蘭州大學基礎醫學院（蘭州?730000）；2. 蘭州大學第二臨床醫學院（蘭州?730000）;

關鍵詞：

培美曲塞多西紫杉醇晚期非小細胞肺癌系統評價 Meta分析隨機對照試驗

DOI：

10.7507/1672-2531.20110160

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價培美曲塞與多西紫杉醇治療晚期非小細胞肺癌（NSCLC）的療效與安全性。
方法　計算機檢索Cochrane Library、PubMed、EMbase、SCI、CBM、CNKI和VIP，同時輔助其他檢索方式，納入培美曲塞與多西紫杉醇比較治療晚期非小細胞肺癌的臨床隨機對照試驗，檢索時間截至2010年11月。由兩位研究者獨立進行文獻篩選、資料提取和方法學質量評價后，采用RevMan 5.0軟件進行Meta分析。
結果　共納入5個研究，合計847例患者。Meta分析結果顯示：在療效方面，培美曲塞與多西紫杉醇相比，兩者在有效率［OR=1.09，95%CI（0.7，1.70）］、疾病控制率［OR=0.99，95%CI（0.75，1.31）］、1年生存率［OR=1.11，95%CI（0.56，2.18）］等方面差異無統計學意義；在安全性方面，與多西紫杉醇相比，培美曲塞可降低中性粒細胞減少［OR=0.09，95%CI（0.05，0.15）］和粒細胞性發熱［OR=0.13，95%CI（0.06，0.29）］、減少脫發［OR=0.20，95%CI（0.12，0.33）］，而在血紅蛋白［OR=1.45，95%CI（0.23，9.06）］、血小板減少［OR=1.46，95%CI（0.59，3.59）］、惡心嘔吐［OR=1.23，95%CI（0.53，2.83）］、疲勞乏力［OR=0.73，95%CI（0.40，1.30）］等方面兩者差異無統計學意義。
結論　當前證據顯示，培美曲塞與多西紫杉醇治療晚期NSCLC的療效相當，但可減少中性粒細胞減少、粒細胞性發熱和脫發等不良反應。

引用本文： 姜金,王曉晶,張璐,林喬,陳淼,田金徽. 培美曲塞與多西紫杉醇比較治療晚期非小細胞肺癌的Meta分析. 中國循證醫學雜志, 2011, 11(8): 960-964. doi: 10.7507/1672-2531.20110160 復制

1.	2 Novello S, Le Chevaller T. Chemotherapy for non-small-cell lung cancer. Part 1: Early-stage disease. Oncology (Williston Park) , 2003, 17(3): 357-364.
2.	National Cancer Institute SEER data. [2009-06-20]. Available at: http: //seer. cancer. gov/statistics/.
3.	Socinski MA, Morris DE, Masters GA, et al . Chemotherapeutic Managenment of Stage Ⅳ Non-small Cell Lung Cancer. Chest , 2003, 123(1 Suppl): 226S-243S.
4.	Di Maio M, Chiodini P, Georgoulias V, et al . Meta-analysis of single-agent chemotherapy compared with combination chemotherapy as second line treatment of advanced non-small-cell lung cancer. J Clin Oncol , 2009, 27(11): 1836-1843.
5.	NCCN非小細胞肺癌臨床實踐指南專家組. 腫瘤學臨床實踐指南(中國版). 第1版. 2008: 20-21.
6.	Ciuleanu T, Brodowicz T, Zielinski C, et al . Maintenance pemetrexed plus best supportive care versus placebo plus best supportive care for non-small-cell lung cancer: a randomised, double-blind, phase 3 study. Lancet , 2009, 374(9699): 1432-1440.
7.	母連軍. 培美曲塞獲準作為非小細胞肺癌治療的一線藥. 國外醫藥抗生素分冊, 2008, 29(6): 285-286.
8.	劉寶. 4種非小細胞肺癌二線藥物治療方案費用比較研究. 中國藥房, 2010, 21(26): 2303-2406.
9.	Higgins JPT, Altman DG. Assessing risk of bias in included studies. Cochrane Handbook for Systematic Review of Inerventions Version 5. 0. 0(update February 2008). The Cochrane Collaboration, 2008. Available from www. cochrane-handbook. org.
10.	陳墨, 周彩存, 張潔. 力比泰與泰素帝治療非小細胞肺癌臨床療比較. 同濟大學(醫學版), 2008, 29(3): 54-57.
11.	胡廣原, 梅齊, 熊慧華, 等. 培美曲塞二鈉單藥對比多西紫杉醇二線治療晚期非小細胞肺癌臨床觀察. 臨床薈萃, 2009, 24(13): 1166-1168.
12.	孟麗娟, 王峻, 劉福銀, 等. 老年晚期非小細胞肺癌單藥二線培美曲塞或多西他賽治療的臨床觀察. 實用老年醫學, 2010, 24(1): 66-68.
13.	馮永, 仲琴, 賈正飛, 等. 培美曲塞、多西紫杉醇治療晚期非小細胞肺癌的療效比較. 山東醫藥, 2010, 50(37): 53-54.
14.	Hanna N, Shepherd FA, Fossella FV, et al . Randomized Phase Ⅲ Trial of Pemetrexed Versus Docetaxel in Patients With Non-Small-Cell Lung Cancer Previously Treated With Chemotherapy. J Clin Oncol , 2004, 22(9): 1589-1597.
15.	Shepherd FA, Dancey J, Ramlau R, et al . prospective randomized trial of docetaxel versus best supportive care in patients with non-small cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol , 2000, 18(10): 2095-2103.
16.	Fossella F, DeVore R, Kerr R, et al . Randomized phase Ⅲ trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small cell lung cancer previously treated with platinum-containing chemotherapy regimens The TAX 320 Non-Small Cell Lung Cancer Study Group. J Clin Oncol , 2000, 18(12): 2354-2362.
17.	郭榮榮, 徐風華, 孫華燕. 多西紫杉醇作為晚期非小細胞肺癌的二線治療藥物的系統評價. 中國循證醫學雜志, 2008, 8(10): 861-868.
18.	Calvert H, An overview of folate metabolism: features relevant to the action and toxicities of antifolate anticancer agents. Semin Oncol , 1999, 26(2 Suppl 6): 3-10.
19.	Adjei AA. Pharmacology and mechanism of action of pemetrexed. Clin lung cancer , 2004, 5 Suppl 2: S51-S55.
20.	Weiss GJ, Langer C, Rosell R, et al . Elderly Patients Bene?t From Second-Line Cytotoxic Chemotherapy: A Subset Analysis of a Randomized Phase III Trial of Pemetrexed Compared With Docetaxel in Patients With Previously Treated Advanced Non–Small-Cell Lung Cancer. J Clin Oncol , 2006, 24(27): 4405-4411.
21.	Asukai Y, Valladares A, Camps C, et al . Cost-effectiveness analysis of pemetrexed versus docetaxel in the second-line treatment of non-small cell lung cancer in Spain: results for the non-squamous histology population. BMC Cancer , 2010, 10: 26.

1. 2 Novello S, Le Chevaller T. Chemotherapy for non-small-cell lung cancer. Part 1: Early-stage disease. Oncology (Williston Park) , 2003, 17(3): 357-364.
2. National Cancer Institute SEER data. [2009-06-20]. Available at: http: //seer. cancer. gov/statistics/.
3. Socinski MA, Morris DE, Masters GA, et al . Chemotherapeutic Managenment of Stage Ⅳ Non-small Cell Lung Cancer. Chest , 2003, 123(1 Suppl): 226S-243S.
4. Di Maio M, Chiodini P, Georgoulias V, et al . Meta-analysis of single-agent chemotherapy compared with combination chemotherapy as second line treatment of advanced non-small-cell lung cancer. J Clin Oncol , 2009, 27(11): 1836-1843.
5. NCCN非小細胞肺癌臨床實踐指南專家組. 腫瘤學臨床實踐指南(中國版). 第1版. 2008: 20-21.
6. Ciuleanu T, Brodowicz T, Zielinski C, et al . Maintenance pemetrexed plus best supportive care versus placebo plus best supportive care for non-small-cell lung cancer: a randomised, double-blind, phase 3 study. Lancet , 2009, 374(9699): 1432-1440.
7. 母連軍. 培美曲塞獲準作為非小細胞肺癌治療的一線藥. 國外醫藥抗生素分冊, 2008, 29(6): 285-286.
8. 劉寶. 4種非小細胞肺癌二線藥物治療方案費用比較研究. 中國藥房, 2010, 21(26): 2303-2406.
9. Higgins JPT, Altman DG. Assessing risk of bias in included studies. Cochrane Handbook for Systematic Review of Inerventions Version 5. 0. 0(update February 2008). The Cochrane Collaboration, 2008. Available from www. cochrane-handbook. org.
10. 陳墨, 周彩存, 張潔. 力比泰與泰素帝治療非小細胞肺癌臨床療比較. 同濟大學(醫學版), 2008, 29(3): 54-57.
11. 胡廣原, 梅齊, 熊慧華, 等. 培美曲塞二鈉單藥對比多西紫杉醇二線治療晚期非小細胞肺癌臨床觀察. 臨床薈萃, 2009, 24(13): 1166-1168.
12. 孟麗娟, 王峻, 劉福銀, 等. 老年晚期非小細胞肺癌單藥二線培美曲塞或多西他賽治療的臨床觀察. 實用老年醫學, 2010, 24(1): 66-68.
13. 馮永, 仲琴, 賈正飛, 等. 培美曲塞、多西紫杉醇治療晚期非小細胞肺癌的療效比較. 山東醫藥, 2010, 50(37): 53-54.
14. Hanna N, Shepherd FA, Fossella FV, et al . Randomized Phase Ⅲ Trial of Pemetrexed Versus Docetaxel in Patients With Non-Small-Cell Lung Cancer Previously Treated With Chemotherapy. J Clin Oncol , 2004, 22(9): 1589-1597.
15. Shepherd FA, Dancey J, Ramlau R, et al . prospective randomized trial of docetaxel versus best supportive care in patients with non-small cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol , 2000, 18(10): 2095-2103.
16. Fossella F, DeVore R, Kerr R, et al . Randomized phase Ⅲ trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small cell lung cancer previously treated with platinum-containing chemotherapy regimens The TAX 320 Non-Small Cell Lung Cancer Study Group. J Clin Oncol , 2000, 18(12): 2354-2362.
17. 郭榮榮, 徐風華, 孫華燕. 多西紫杉醇作為晚期非小細胞肺癌的二線治療藥物的系統評價. 中國循證醫學雜志, 2008, 8(10): 861-868.
18. Calvert H, An overview of folate metabolism: features relevant to the action and toxicities of antifolate anticancer agents. Semin Oncol , 1999, 26(2 Suppl 6): 3-10.
19. Adjei AA. Pharmacology and mechanism of action of pemetrexed. Clin lung cancer , 2004, 5 Suppl 2: S51-S55.
20. Weiss GJ, Langer C, Rosell R, et al . Elderly Patients Bene?t From Second-Line Cytotoxic Chemotherapy: A Subset Analysis of a Randomized Phase III Trial of Pemetrexed Compared With Docetaxel in Patients With Previously Treated Advanced Non–Small-Cell Lung Cancer. J Clin Oncol , 2006, 24(27): 4405-4411.
21. Asukai Y, Valladares A, Camps C, et al . Cost-effectiveness analysis of pemetrexed versus docetaxel in the second-line treatment of non-small cell lung cancer in Spain: results for the non-squamous histology population. BMC Cancer , 2010, 10: 26.

《中國循證醫學雜志》

培美曲塞與多西紫杉醇比較治療晚期非小細胞肺癌的Meta分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《中國循證醫學雜志》

培美曲塞與多西紫杉醇比較治療晚期非小細胞肺癌的Meta分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料