摘要
目的:系统评价吉西他滨在非小细胞肺癌(NSCLC)治疗中的临床疗效、安全性及地位。方法:检索Medline、EMbase、Cancerdit、CBM、CNKI等文献数据库。由2名评价者独立评价并交叉核对纳入研究质量,对同质研究采用RevMan4.2.2软件进行Meta分析。结果:共纳入12个随机对照试验(RCT),1715例NSCLC患者,所有研究均未报道随机方案的隐藏情况及是否采用盲法。Meta分析结果显示:(1)吉西他滨+顺铂方案(GP)化疗后反应率、中位疾病进展期高于吉西他滨+卡铂方案(GC),中位生存期相似,但消化道反应较高;(2)GP方案反应率、中位生存期、中位疾病进展期均高于足叶乙苷+顺铂方案(EP),但其骨髓毒性较高;(3)GP方案与长春瑞滨+顺铂方案(NP)反应率相似,但骨髓毒性较高;(4)GP方案与吉西他滨单药方案的反应率、中位生存期、1年生存率相似,但消化道反应较高;(5)长春瑞滨+吉西他滨+顺铂方案(VGP)反应率高于长春瑞滨+吉西他滨方案(VG),中位生存期、中位疾病进展期2组相似,但VGP方案骨髓毒性较高;(6)吉西他滨+多西紫杉醇方案(DG)反应率、中位生存期高于多西紫杉醇单药方案,生存质量评价更有优势,但骨髓毒性较高;(7)吉西他滨50mg·min-1×30min静脉滴注方案与10mg·min-1×150min静脉滴注方案在反应率、中位生存期、中位疾病进展期、1年期生存率方面均相似,但后者骨髓毒性较高。所有研究共报道了17例治疗相关性死亡。结论:吉西他滨治疗NSCLC临床疗效确切,但骨髓毒性和消化道反应相对较高。
OBJECTIVE： To evaluate the clinical efficacy, safety and status of gemcitabine for non-small-cell lung cancer （NSCLC） systematically. METHODS： Included studies retrieved from Medline, EMbase, Cancerdit, CBM and CNKI were evaluated by two reviewers alone and cross-checked. The Meta-analyses of studies were conducted using RevMan 4.2.2 software. RESULTS： 12 studies containing 1,715 patients with NSCLC were included.12 studies were all reported randomly（RCT）. Hidden information and application of blind method in therapy were not reported. Results of metanalysis indicated that： （1）After chemotherapy reaction rate and the level of median disease development in GP therapy （gemcitabine combined with cisplatin） were higher than in GC therapy （gemcitabine combined with carboplatin） with similar median survival time and strong reaction of digestive tract; （2）Reaction rate; the level of median disease development and median survival time in GP therapy than in EP therapy （etoposide combined with cisplatin） but with strong toxicity in bone marrow; （3）Reaction rate of GP therapy was same to NP therapy （vinorelbine combined with cisplatin） with strong toxicity in bone marrow; （4）Reaction rate, median survival time and one-year survival rate in GP therapy were similar to in gemcitabine alone therapy with intense reaction in digestive tract; （5）Reaction rate in VGP therapy （vinorelbine, gemcitabine combined with cisplatin） was higher than in VG therapy （vinorelbine combined with gemcitabine） with strong toxicity in bone marrow but they had same the level of median disease development and median survival time; （6）Reaction rate, median survival time in DG therapy （gemcitabine combined with taxotere） were higher than in taxotere alone therapy with advanced the quality of life and strong toxicity in bone marrow; （7）Reaction rate, median survival time, the level of median disease development and one-year survival rate in therapy of gemcitabine （50 mg-min^-1×30 min, i.v） were similar to that of gemcitabine （10 mg-min^-l× 150 min, i.v） with intense toxicity in bone marrow. 17 cases of related death were reported in all researches. CONCLUSION： Gemcitabine has exact clinical efficacy and causes strong toxicity in bone marrow and reaction in digestive tract.
出处
《中国药房》
CAS
CSCD
北大核心
2010年第8期706-710,共5页
China Pharmacy
基金
上海医院药学科研基金肿瘤药学专项(2008-YY-0208)
关键词
吉西他滨
非小细胞肺癌
系统评价
Gemcitabine
Non-small-cell lung cancer
Systematic review
