消融治疗联合表皮生长因子受体酪氨酸激酶抑制剂治疗晚期非小细胞肺癌：一项随机对照试验的荟萃分析
Ablation Therapy Combined with EGFR TKIs in the Treatment of Advanced Non-Small Cell Lung Cancer: A Meta-Analysis of Randomized Controlled Trials.
作者信息
Li Lu-Zhen, Wu Jia-Ming, Chen Ting, Zhao Liang-Chen, Zhuang Juan-Na, Hong Hui-Si, Zhang Ao, Zhang Hua-Tang, Fang Can-Tu
机构信息
Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan 528400, China.
出版信息
Evid Based Complement Alternat Med. 2021 May 7;2021:6624429. doi: 10.1155/2021/6624429. eCollection 2021.
OBJECTIVE
Systematically evaluate the efficacy of physical ablation combined with TKI in the treatment of advanced non-small cell lung cancer (NSCLC).
METHODS
We performed a comprehensive search of databases including OVID, PubMed, EMBASE, the Cochrane Library, and three Chinese databases (China National Knowledge Infrastructure, Wanfang Database, and Chongqing Weipu Database). The aim was to identify randomized controlled trials (RCT) investigating physical ablation as the treatment for advanced NSCLC. We also evaluated the methodological quality of the included studies and summarized the data extracted for meta-analysis with Review Manager 5.3.
RESULTS
A total of 9 studies, including 752 patients, were evaluable. The meta-analysis results show that the complete response rate (CRR) (RR: 2.23, 95% CI: 1. 46 to 3.40, 0.01), partial response rate (PRR) (RR: -2.25, 95% CI: 1.41 to 3.59, 0.01), and disease control rate (DCR) (RR: -2.80, 95% CI: 1.64 to 4.80, < 0.01) of patients with advanced NSCLC who received physical ablation combined with TKI therapy were higher than those who did not receive physical ablation therapy. The control groups from seven of the studies had a total of 606 patients with targeted therapies and chemotherapy. The complete response rate was (CRR) (RR: 2.48, 2.4895% CI: 1.55 to 2.47, 0.01), partial response rate (PRR) (RR: -1.66, 95% CI: 1.20 to 2.31, < 0.01), and disease control rate (DCR) (RR: -2.68, 95% CI: 1.41 to 5.06, < 0.01) for patients with advanced NSCLC who had received physical ablation combined with targeted therapies and chemotherapy, compared to patients who had not received physical ablation therapy. This difference was statistically significant. Above all, these results showed that the clinical efficacy of physical ablation combined EGFR-TKIs therapy (regardless of whether it was combined with chemotherapy) was better than that of EGFR-TKIs therapy alone.
CONCLUSION
Physical ablation combined with TKI treatment in patients with advanced NSCLC can improve efficacy.
目的
系统评价物理消融联合酪氨酸激酶抑制剂（TKI）治疗晚期非小细胞肺癌（NSCLC）的疗效。
方法
我们全面检索了多个数据库，包括OVID、PubMed、EMBASE、Cochrane图书馆以及三个中文数据库（中国知网、万方数据库和重庆维普数据库）。目的是识别将物理消融作为晚期NSCLC治疗方法的随机对照试验（RCT）。我们还评估了纳入研究的方法学质量，并使用Review Manager 5.3对提取的数据进行汇总以进行荟萃分析。
结果
共有9项研究、752例患者可纳入评估。荟萃分析结果显示，接受物理消融联合TKI治疗的晚期NSCLC患者的完全缓解率（CRR）（风险比[RR]：2.23，95%置信区间[CI]：1.46至3.40，P = 0.01）、部分缓解率（PRR）（RR：2.25，95% CI：1.41至3.59，P = 0.01）和疾病控制率（DCR）（RR：2.80，95% CI：1.64至4.80，P < 0.01）高于未接受物理消融治疗的患者。其中7项研究的对照组共有606例接受靶向治疗和化疗的患者。与未接受物理消融治疗的患者相比，接受物理消融联合靶向治疗和化疗的晚期NSCLC患者的完全缓解率（CRR）（RR：2.48，95% CI：1.55至2.47，P = 0.01）、部分缓解率（PRR）（RR：1.66，95% CI：1.20至2.31，P < 0.01）和疾病控制率（DCR）（RR：2.68，95% CI：1.41至5.06，P < 0.01）。这种差异具有统计学意义。最重要的是，这些结果表明物理消融联合表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗（无论是否联合化疗）比单纯EGFR-TKIs治疗的临床疗效更好。
结论
物理消融联合TKI治疗晚期NSCLC患者可提高疗效。
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