CAJ | 학술논문

目的：系统评价重组人血管内皮抑素联合同步放化疗与同步放化疗比较治疗晚期非小细胞肺癌( NSCLC)的有效性和安全性。方法计算机系统检索Cochrane图书馆、PubMed、中国生物医学文献数据库、中国学术期刊全文数据库、EMbase、维普数据库、万方数据库所收录的相关研究,检索时间截止至2013年8月。研究对象为NSCLC患者,治疗组采用重组人血管内皮抑素联合同步放化疗,对照组仅用同步放化疗,比较两组疗效及安全性。使用Cochrane 手册5.1.0版的质量评价标准对纳入研究进行质量评价,使用RevMan 5.1.0版软件进行数据分析。结果最终纳入5项研究,共217例患者。 Meta分析结果表明：与对照组比较,治疗组有效率提高[OR=2.62,95%CI(1.41,4.86),P=0.002]。在临床获益率[OR=2.08,95%CI(0.92,4.73),P=0.08]、1年生存率[OR=1.18,95%CI(0.53,2.66),P=0.68]、生活质量改善[OR=1.57,95%CI(0.40,6.07),P=0.52]、白细胞减少[OR=1.25,95%CI(0.72,2.17),P=0.43]、放射性食管炎[OR=1.16,95%CI(0.42,3.21),P=0.77]、放射性肺炎[OR=2.47,95%CI(0.34,17.68),P=0.37]等方面,两组均差异无统计学意义。结论与仅用同步放化疗比较,重组人血管内皮抑素联合同步放化疗治疗晚期NSCLC可提高疗效,两组生活质量改善情况及毒副反应发生率相当。受纳入研究质量限制和可能存在的发表偏倚影响,上述结论尚需更多高质量的随机对照试验加以验证。
목적：계통평개중조인혈관내피억소연합동보방화료여동보방화료비교치료만기비소세포폐암( NSCLC)적유효성화안전성。방법계산궤계통검색Cochrane도서관、PubMed、중국생물의학문헌수거고、중국학술기간전문수거고、EMbase、유보수거고、만방수거고소수록적상관연구,검색시간절지지2013년8월。연구대상위NSCLC환자,치료조채용중조인혈관내피억소연합동보방화료,대조조부용동보방화료,비교량조료효급안전성。사용Cochrane 수책5.1.0판적질량평개표준대납입연구진행질량평개,사용RevMan 5.1.0판연건진행수거분석。결과최종납입5항연구,공217례환자。 Meta분석결과표명：여대조조비교,치료조유효솔제고[OR=2.62,95%CI(1.41,4.86),P=0.002]。재림상획익솔[OR=2.08,95%CI(0.92,4.73),P=0.08]、1년생존솔[OR=1.18,95%CI(0.53,2.66),P=0.68]、생활질량개선[OR=1.57,95%CI(0.40,6.07),P=0.52]、백세포감소[OR=1.25,95%CI(0.72,2.17),P=0.43]、방사성식관염[OR=1.16,95%CI(0.42,3.21),P=0.77]、방사성폐염[OR=2.47,95%CI(0.34,17.68),P=0.37]등방면,량조균차이무통계학의의。결론여부용동보방화료비교,중조인혈관내피억소연합동보방화료치료만기NSCLC가제고료효,량조생활질량개선정황급독부반응발생솔상당。수납입연구질량한제화가능존재적발표편의영향,상술결론상수경다고질량적수궤대조시험가이험증。
Objective To evaluate the effectiveness and safety of recombinant human endostatin combined with concurrent chemoradiotherapy versus concurrent chemoradiotherapy for advanced non small cell lung cancer ( NSCLC) . Methods Electronic databases including the Cochrane library, PubMed, the Chinese biomedical literature database, China national knowledge internet(,EMbase,VIP and Wanfang database system were searched,until August,2013. The inclusion criteria was efficacy and safety studies of randomized controlled clinical studies in which recombinant human endostatin combined with concurrent chemoradiotherapy was compared with concurrent chemoradiotherapy alone for patients with advanced NSCLC. Cochrane handbook 5. 1. 0 was applied in evaluating the quality of included trials and RevMan 5. 1. 0 software was used for data analysis.Results Five studies including 217 cases of advanced NSCLC were included. The results of the meta-analysis exhibited that compared with concurrent chemoradiotherapy alone, recombinant human endostatin combined with concurrent chemoradiotherapy could increase effective rate [OR=2. 62,95%CI(1. 41,4. 86),P=0. 002]. But there were no significant differences in clinical benefit rate [OR=2. 08,95%CI(0. 92,4. 73),P=0. 08],one year survival rate [OR=1. 18,95%CI(0. 53,2. 66),P=0. 68], improvement in quality of life [OR=1. 57,95%CI(0. 40,6. 07),P=0. 52],rate of leucopenia [OR=1. 25,95%CI(0. 72,2. 17), P=0.43],radioactive esophagitis [OR=1. 16,95%CI(0. 42,3. 21),P=0. 77] and radiation pneumonitis [OR=2. 47,95%CI (0. 34,17. 68),P=0. 37]. Conclusion Compared with concurrent chemoradiotherapy alone,recombinant human endostatin combined with concurrent chemoradiotherapy may be more effective for advanced NSCLC,whereas improvement of life quality and toxicities are similar. For the quality restriction and possible publication bias of the included studies,more high quality randomized controlled trials are required to further verify this conclusion.