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Random prospective study of vindesine versus vindesine plus high-dose cisplatin versus vindesine plus cisplatin plus mitomycin C in advanced non-small-cell lung cancer.长春地辛对比长春地辛加用高剂量顺铂对比长春地辛加用顺铂加用丝裂霉素C治疗晚期非小细胞肺癌的随机前瞻性研究
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丝裂霉素在非小细胞肺癌治疗中的作用：一项文献的系统评价与荟萃分析

The role of mitomycin in the treatment of non-small cell lung cancer: a systematic review with meta-analysis of the literature.

作者信息

Sculier J P, Ghisdal L, Berghmans T, Branle F, Lafitte J J, Vallot F, Meert A P, Lemaitre F, Steels E, Burniat A, Mascaux C

出版信息

Br J Cancer. 2001 May 4;84(9):1150-5. doi: 10.1054/bjoc.2001.1742.

DOI:10.1054/bjoc.2001.1742
PMID:11336463
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2363891/
Abstract

In order to clarify the role of mitomycin (MMC) in the treatment of NSCLC, we performed a systematic review of the literature and qualitatively assessed the selected studies using the ELCWP and Chalmers scales. 5 trials (202 patients) assessed the activity of MMC as single-agent chemotherapy in NSCLC. The overall response rate was 25% (95% Cl 19-31). In 10 randomized phase III trials (1769 patients), we studied the role of MMC in combination therapy. A meta-analysis, based on the available published data, failed to show any survival advantage of the MMC containing regimens (hazard ratio = 0.95; 95% Cl 0.83-1.10). Finally, 4 eligible trials (139 patients) assessed the activity of MMC regimens as salvage therapy, 3 in combination with vindesine and one with cisplatin and vinblastine. The overall response rate for the MMC-vindesine regimen was 10.5% (95% Cl 1.7-19.4). In conclusion, MMC is an active drug for NSCLC but does not improve survival when combined with other active drugs, particularly cisplatin. Its use for salvage therapy appears to be associated with marginal activity only.

摘要

为了阐明丝裂霉素（MMC）在非小细胞肺癌（NSCLC）治疗中的作用，我们对文献进行了系统回顾，并使用ELCWP和查尔默斯量表对所选研究进行了定性评估。5项试验（202例患者）评估了MMC作为NSCLC单药化疗的活性。总缓解率为25%（95%可信区间19 - 31）。在10项随机III期试验（1769例患者）中，我们研究了MMC在联合治疗中的作用。基于现有已发表数据的荟萃分析未能显示含MMC方案有任何生存优势（风险比 = 0.95；95%可信区间0.83 - 1.10）。最后，4项符合条件的试验（139例患者）评估了MMC方案作为挽救治疗的活性，3项与长春地辛联合，1项与顺铂和长春花碱联合。MMC - 长春地辛方案的总缓解率为10.5%（95%可信区间1.7 - 19.4）。总之，MMC是一种对NSCLC有效的药物，但与其他活性药物联合使用时并不能提高生存率，尤其是与顺铂联合时。其用于挽救治疗似乎仅与有限的活性相关。