Liu Zi-Li, Wang Qian, Wang Ming, Wang Bin, Huang Li-Nian
Department of Respiratory Diseases, Huaibei Miners General Hospital, Anhui Huaibei 235000, China.
Intensive Care Unit, Suzhou Municipal Hospital, Anhui Suzhou 234000, China.
J Cancer Res Ther. 2018 Jun;14(Supplement):S437-S443. doi: 10.4103/0973-1482.176174.
To systematically review the efficacy and safety of low molecular weight heparin (LMWH) in treating patients with lung cancer received chemotherapy.
Databases including PubMed, The Cochrane Library, Excerpt Medica Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP, and Wanfang Data were searched for the randomized controlled trials (RCTs) about LMWH in treating patients with lung cancer received chemotherapy from the establishment to May 31, 2015. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed quality of the included studies. Meta-analysis was then performed by using Review Manager 5.3 (Cochrane Collaboration, Oxford, UK) software.
A total of eight RCTs involving 952 patients were finally included. Meta-analysis showed that compared with the control group, LMWH significantly improved the 1- and 2-year overall survival (OS) rates of the patients with lung cancer received chemotherapy (risk ratio [RR] =1.65, 95% confidence interval [95% CI] [1.20-2.26], P = 0.002; RR = 2.63, 95% CI [1.40-4.94], P = 0.003, respectively), and significantly reduced the incidence of venous thromboembolism (VTE) (RR = 0.40, 95% CI [0.23-0.69], P = 0.001), not significantly increased the incidence of major bleeding events and thrombocytopenia (RR = 1.29, 95% CI [0.57-2.96], P = 0.54; RR = 0.86, 95% CI [0.69-1.07], P = 0.18, respectively), and not significantly improved the overall response rate (RR = 1.24, 95% CI [0.98-1.57], P = 0.07).
LMWH improves the 1- and 2-year OS rates of the patients with lung cancer received chemotherapy and reduces the incidence of VTE, not increase the incidence of major bleeding events and thrombocytopenia. These show that there is a certain effect of LMWH, and the security is good.
系统评价低分子量肝素（LMWH）在接受化疗的肺癌患者中的疗效和安全性。
检索包括PubMed、Cochrane图书馆、医学文摘数据库、中国生物医学文献数据库、中国知网、维普和万方数据在内的数据库，查找自建库至2015年5月31日关于LMWH治疗接受化疗的肺癌患者的随机对照试验（RCT）。根据纳入和排除标准，两名研究者独立筛选文献、提取数据并评估纳入研究的质量。然后使用Review Manager 5.3（英国牛津Cochrane协作网）软件进行荟萃分析。
最终纳入8项RCT，共952例患者。荟萃分析显示，与对照组相比，LMWH显著提高了接受化疗的肺癌患者1年和2年的总生存率（风险比[RR]=1.65，95%置信区间[95%CI][1.20 - 2.26]，P = 0.002；RR = 2.63，95%CI[1.40 - 4.94]，P = 0.003），并显著降低了静脉血栓栓塞（VTE）的发生率（RR = 0.四0，95%CI[0.23 - 0.69]，P = 0.001），未显著增加大出血事件和血小板减少症的发生率（RR = 1.29，95%CI[0.57 - 2.96]，P = 0.54；RR = 0.86，95%CI[0.69 - 1.07]，P = 0.18）且未显著提高总缓解率（RR = 1.24，95%CI[0.98 - 1.57]，P = 0.07）。
LMWH提高了接受化疗的肺癌患者1年和2年的总生存率并降低了VTE的发生率，未增加大出血事件和血小板减少症的发生率。这些表明LMWH有一定疗效且安全性良好。
