Wailoo A, Sutton A, Morgan A
Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK.
Br J Cancer. 2009 Feb 10;100(3):436-41. doi: 10.1038/sj.bjc.6604863.
We aimed to assess the incidence of febrile neutropenia in patients with non small cell lung cancer treated with docetaxel as second line chemotherapy by systematic review and meta-analysis of clinical studies. Published studies were retrieved and included if they considered docetaxel at the licensed dose after a previous chemotherapy regimen, and reported the proportion of patients getting FN. Meta-analysis was conducted to estimate the proportion of patients who experience one or more episodes of FN. The pooled, random effects meta-analysis estimate for the proportion of patients who experience one or more episodes of FN on docetaxel was 5.95% (95% CI 4.22-8.31) based on 13 studies, comprising 1609 patients. No significant differences were seen either between studies that permitted the use of prophylactic granulocyte colony-stimulating factors or between phase II and phase III trials.Evidence from randomised controlled trials suggests that the incidence of FN with docetaxel is around 6% and therefore an important factor to consider in the choice of the chemotherapy regimen.
我们旨在通过对临床研究进行系统评价和荟萃分析，评估多西他赛作为二线化疗药物治疗非小细胞肺癌患者时发热性中性粒细胞减少症的发生率。检索已发表的研究，如果这些研究考虑了在前一化疗方案后使用许可剂量的多西他赛，并报告了发生发热性中性粒细胞减少症（FN）的患者比例，则将其纳入。进行荟萃分析以估计经历一次或多次FN发作的患者比例。基于13项研究（共1609例患者），多西他赛治疗中经历一次或多次FN发作的患者比例的汇总随机效应荟萃分析估计值为5.95%（95%置信区间4.22 - 8.31）。在允许使用预防性粒细胞集落刺激因子的研究之间以及II期和III期试验之间均未观察到显著差异。随机对照试验的证据表明，多西他赛导致FN的发生率约为6%，因此是化疗方案选择中需要考虑的一个重要因素。
