Ge Wei, Cao De-dong, Wang Hui-min, Jie Fang-fang, Zheng Yong-fa, Chen Yu
Department of Oncology, RenMin Hospital of Wu Han University, WuHan, China.
Asian Pac J Cancer Prev. 2011;12(10):2705-11.
To evaluate the clinical efficacy and safety of rh-endostatin (Endostar) combined with chemotherapy in the treatment of patients with non-small cell lung cancer (NSCLC), we selected data from the Cochrane Library, EMBASE, Medline, SCI, CBM, CNKI, etc to obtain all clinical controlled trials, including the addition of endostar to chemotherapy in advanced NSCLC patients. The quality of included trials was evaluated by two reviewers independently. The software RevMan 5.0 was provided by Cochrane Collaboration and used for meta-analyses. Fifteen trials with 1335 patients were included according to the including criterion. All trials were randomized controlled trials, and two trials were adequate in reporting randomization. Thirteen trials didn't mention the blinding methods. Meta-analysis indicated that the NPE arm (Vinorelbine+ cisplatin+Endostar) had a different response rate compared with NP(Vinorelbine+ cisplatin) arm (OR2.16, 95%CI 1.57 to 2.99). The incidences of severe Leukopenia (OR0.94, 95%CI 0.66 to 1.32) and severe thrombocytopenia (OR 1.00, 95%CI 0.64 to 1.57) and Nausea and vomiting (OR 0.85, 95%CI 0.61 to 1.20) were similar in the NPE arm compared with those in the NP arm. The NPE plus radiotherapy(RT) arm had a similar response rate compared with NP plus RT arm (OR 2.39, 95%CI 0.99 to 5.79). The incidences of Leukopenia (OR0.83, 95%CI 0.35 to 1.94) and thrombocytopenia (OR 0.78, 95%CI 0.19 to 3.16) and radiation esophagitis (OR 1.00, 95%CI 0.40 to 2.49)were similar in the NPE plus RT arm compared with those in the NP plus RT arm. Our results suggest that in the treatment of advanced NSCLCs, Endostar in combination with platinum-based chemotherapy can improve the response rate without obviously increasing side effects.
为评估重组人血管内皮抑素（恩度）联合化疗治疗非小细胞肺癌（NSCLC）患者的临床疗效及安全性，我们从考克兰图书馆、EMBASE、Medline、SCI、中国生物医学文献数据库（CBM）、中国知网（CNKI）等数据库中筛选数据，以获取所有临床对照试验，包括晚期NSCLC患者化疗联合恩度的试验。由两名评价员独立评估纳入试验的质量。采用考克兰协作网提供的RevMan 5.0软件进行荟萃分析。根据纳入标准，共纳入15项试验，涉及1335例患者。所有试验均为随机对照试验，其中两项试验在随机化报告方面较为充分。13项试验未提及盲法。荟萃分析表明，NPE组（长春瑞滨+顺铂+恩度）与NP组（长春瑞滨+顺铂）相比，缓解率有所不同（OR=2.16，95%CI为1.57至2.99）。NPE组与NP组相比，严重白细胞减少症（OR=0.94，95%CI为0.66至1.32）、严重血小板减少症（OR=1.00，95%CI为0.64至1.57）以及恶心呕吐（OR=0.85，95%CI为0.61至1.20）的发生率相似。NPE联合放疗（RT）组与NP联合RT组相比，缓解率相似（OR=2.39，95%CI为0.99至5.79）。NPE联合RT组与NP联合RT组相比，白细胞减少症（OR=0.83，95%CI为0.35至1.94）、血小板减少症（OR=0.78，95%CI为0.19至3.16）以及放射性食管炎（OR=1.00，95%CI为0.40至2.49）的发生率相似。我们的结果表明，在晚期NSCLC的治疗中，恩度联合铂类化疗可提高缓解率，且不会明显增加副作用。
