CAJ | 학술논문

目的评价吉非替尼与多西紫杉醇作为晚期非小细胞肺癌( NSCLC)二线治疗的临床疗效及安全性.方法计算机检索PubMed、EMBASE、Cochrane图书馆、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库和万方数据库,纳入吉非替尼与多西紫杉醇治疗既往接受过化疗的局部晚期NSCLC的临床随机对照试验(RCT),依据Cochrane系统评价手册5.0.2质量评价标准进行质量评价,采用RevMan5.0软件进行meta分析.结果最终纳入4个RCT(2 257例).meta分析结果显示,吉非替尼与多西紫杉醇相比,可以提高局部晚期NSCLC患者的客观缓解率、生活质量改善率(P＜0.05)；并且其3～4级不良反应发生率低(P＜0.05).而在总生存率、症状改善率和无进展生存率方面,差异无统计学意义(P＞0.05).结论吉非替尼用于治疗既往接受过化疗的局部晚期或转移性NSCLC的客观缓解率优于多西紫杉醇,而且患者生活质量改善显著,其药物耐受性和安全性更高,目前可作为一种有效的二线治疗药物积极推广应用,但生存期方面仍需进一步研究.
목적 평개길비체니여다서자삼순작위만기비소세포폐암( NSCLC)이선치료적림상료효급안전성.방법 계산궤검색PubMed、EMBASE、Cochrane도서관、중국기간전문수거고、중국생물의학문헌수거고、중문과기기간전문수거고화만방수거고,납입길비체니여다서자삼순치료기왕접수과화료적국부만기NSCLC적림상수궤대조시험(RCT),의거Cochrane계통평개수책5.0.2질량평개표준진행질량평개,채용RevMan5.0연건진행meta분석.결과 최종납입4개RCT(2 257례).meta분석결과현시,길비체니여다서자삼순상비,가이제고국부만기NSCLC환자적객관완해솔、생활질량개선솔(P＜0.05)；병차기3～4급불량반응발생솔저(P＜0.05).이재총생존솔、증상개선솔화무진전생존솔방면,차이무통계학의의(P＞0.05).결론 길비체니용우치료기왕접수과화료적국부만기혹전이성NSCLC적객관완해솔우우다서자삼순,이차환자생활질량개선현저,기약물내수성화안전성경고,목전가작위일충유효적이선치료약물적겁추엄응용,단생존기방면잉수진일보연구.
Objective To evaluate the clinical efficacy and safety of gefitinib versus docetaxel in previously treated non-small cell lung cancer.Methods Literatures were searched on database like PubMed,EMBASE,Cochrane Library,Chinese Biomedical Literature Database,China Journal Full Text Database,and Chinese Scientific Journals Full Text Database and Wanfang Database.All the relevant randomized controlled trials that gefitinib versus docetaxel in non-small cell lung cancer patients who have previously received chemotherapy were collected,and the quality of the included trials was assessed by Cochrane Systematic Review Handbook 5.0.2. Meta-analyses were conducted by RevMan 5.0 software. Results Four studies were involved and 2 257 patients were included.Meta-analysis showed that gefitinib can improve objective response rate and quality of life in local advanced non-small cell lung cancer patients who have previously received chemotherapy compared with docetaxel ( P ＜ 0.05) ； and it's low in the 3-4 level adverse reaction rate (P ＜ 0.05 ).But there was no significant difference in overall survival rate,symptoms improving rate and progression-free survival rate (P ＞ 0.05).Conclusions Gefitinib is superior to docetaxel in the objective response rate with local advanced or metastatic non-small cell lung cancer patients who have previously received chemotherapy.The quality of life of the patients is improved significantly.Because of it has high drug tolerance and high safety,gefitinib can be actively promoted application as a kind of current effective second-line drugs at present,but the survival aspect needs to be studied further.