Xin Wen-Xiu, Fang Luo, Fang Qi-Lu, Zheng Xiao-Wei, Ding Hai-Ying, Huang Ping
Laboratory of Clinical Pharmacy Key Laboratory of Head and Neck Translational Research of Zhejiang Province Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Hangzhou, P.R. China.
Medicine (Baltimore). 2018 Mar;97(9):e0035. doi: 10.1097/MD.0000000000010035.
To assess the association between hypoglycemic agents and prognosis of lung cancer patients with diabetes.
A comprehensive literature search was performed in PubMed, Web of Science, Embase, and Cochrane Library until May 2017. The search yielded 2593 unique citations, of which 18 articles met inclusion criteria. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated by a fixed-effects or random-effects model.
The pooled HRs favoring metformin users were 0.77 for overall survival (OS) (n = 15, 95% CI: 0.68-0.86) and 0.50 for disease-free survival (n = 5, 95% CI: 0.39-0.64). One study assessed the relationship between metformin and cancer-specific survival (CSS), reporting no significant results. No significant association between insulin and OS (n = 2, HR: 0.95, 95% CI: 0.79-1.13) or CSS (n = 2, HR: 1.03, 95% CI: 0.76-1.41) was noted. One study evaluated association of sulfonylureas with lung cancer survival and reported no clinical benefit (HR: 1.10, 95% CI: 0.87-1.40). One study reported no association of thiazolidinediones with lung cancer survival (HR: 1.04, 95% CI: 0.65-1.66).
This meta-analysis demonstrated that metformin exposure might improve survival outcomes in lung cancer patients with diabetes.
评估降糖药物与糖尿病肺癌患者预后之间的关联。
截至2017年5月，在PubMed、科学网、Embase和考克兰图书馆进行了全面的文献检索。检索得到2593条独特的引文，其中18篇文章符合纳入标准。采用固定效应或随机效应模型计算风险比（HR）和95%置信区间（95%CI）。
使用二甲双胍的患者总生存期（OS）的合并HR为0.77（n = 15，95%CI：0.68 - 0.86），无病生存期（DFS）的合并HR为0.50（n = 5，95%CI：0.39 - 0.64）。一项研究评估了二甲双胍与癌症特异性生存期（CSS）之间的关系，未报告显著结果。未发现胰岛素与OS（n = 2，HR：0.95，95%CI：0.79 - 1.13）或CSS（n = 2，HR：1.03，95%CI：0.76 - 1.41）之间存在显著关联。一项研究评估了磺脲类药物与肺癌生存期的关联，未报告临床获益（HR：1.10，95%CI：0.87 - 1.40）。一项研究报告噻唑烷二酮类药物与肺癌生存期无关联（HR：1.04，95%CI：0.65 - 1.66）。
这项荟萃分析表明，二甲双胍可能改善糖尿病肺癌患者的生存结局。
