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[吉西他滨联合顺铂或多西他赛联合顺铂热化疗用于晚期非小细胞肺癌的系统评价]

[Thermo-chemotherapy of GP or TP for advanced non-small cell lung cancer: a systematic review].

作者信息

Mi Denghai, Li Zheng, Yang Kehu, Cao Nong, Tian Jinhui, Ma Bin

机构信息

Evidence Based Medicine Center of Lanzhou University, Lanzhou 730000, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2012 Aug;15(8):456-64. doi: 10.3779/j.issn.1009-3419.2012.08.02.

Abstract

BACKGROUND

Advanced non-small cell lung cancer (NSCLC) is characterized by poor treatment efficacy and short survival time. Clinical trials have shown that the combination of chemotherapy with thermotherapy exhibits strong efficacy. We performed this meta-analysis to evaluate the clinical efficacy and safety of gemcitabine plus cisplatin (GP) and paclitaxel plus cisplatin (TP) combined with thermotherapy in the treatment of NSCLC, as well as to provide reference for clinical practice and future research.

METHODS

We searched international (Cochrane Library, PubMed, and EMBASE) and Chinese (CBM, CNKI, VIP and Wanfang) databases for relevant articles and imported other retrievable sources, such as tracing-related references. We also corresponded with other authors to obtain certain inaccessible information. Data from all relevant randomized controlled trials (RCT) were collected to compare GP or TP thermochemotherapy with GP or TP chemotherapy alone. The quality of the included studies was assessed by adequate outcome-based standards and clinical circumstances. The meta-analysis was conducted using RevMan 5.1.

RESULTS

Fifteen RCTs involving 952 patients were included in this meta-analysis. The results showed that the thermochemotherapy group had higher rates of improvement in quality of life (OR=3.84, 95%CI: 2.61-5.64), survival at 1 year (HR=1.94, 95%CI: 1.21-3.12), and survival at 2 years (HR=2.05, 95%CI: 1.18-3.58) compared with the chemotherapy group, with the differences between them being significant. However, these groups did not differ in other indicators of treatment effectiveness, such as myelosuppression, alimentary canal reactions, hepatic lesions, and diarrhea.

CONCLUSIONS

Compared with chemotherapy alone, thermochemotherapy can improve survival rates and curative effects, ameliorate symptoms, and enhance the quality of life of patients with advanced NSCLC, and it has an acceptable safety profile. The results of this meta-analysis warrant further investigation with a larger sample size and using a high-quality RCT design.

摘要

背景

晚期非小细胞肺癌(NSCLC)的特点是治疗效果差、生存时间短。临床试验表明,化疗与热疗联合具有很强的疗效。我们进行了这项荟萃分析,以评估吉西他滨联合顺铂(GP)和紫杉醇联合顺铂(TP)与热疗联合治疗NSCLC的临床疗效和安全性,并为临床实践和未来研究提供参考。

方法

我们检索了国际数据库(Cochrane图书馆、PubMed和EMBASE)和中国数据库(CBM、CNKI、VIP和万方)中的相关文章,并导入其他可检索来源,如追溯相关参考文献。我们还与其他作者通信以获取某些无法获取的信息。收集所有相关随机对照试验(RCT)的数据,以比较GP或TP热化疗与单纯GP或TP化疗。纳入研究的质量通过基于充分结果的标准和临床情况进行评估。使用RevMan 5.1进行荟萃分析。

结果

本荟萃分析纳入了15项涉及952例患者的RCT。结果显示,与化疗组相比,热化疗组在生活质量改善率(OR=3.84,95%CI:2.61-5.64)、1年生存率(HR=1.94,95%CI:1.21-3.12)和2年生存率(HR=2.05,95%CI:1.18-3.58)方面更高,两组之间的差异具有统计学意义。然而,这些组在其他治疗效果指标上没有差异,如骨髓抑制、消化道反应、肝脏病变和腹泻。

结论

与单纯化疗相比,热化疗可以提高晚期NSCLC患者的生存率和疗效,改善症状,提高生活质量,并且具有可接受的安全性。本荟萃分析的结果值得进一步开展更大样本量、采用高质量RCT设计的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fda4/5999956/3878bba7fa4b/zgfazz-15-8-456-1.jpg

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