CAJ | 학술논문

目的:通过Meta分析探讨沙利度胺联合化疗在晚期非小细胞肺癌患者中的应用价值.方法:由两位独立评价者按相同检索策略检索中国生物医学文献库等资源中的文献,根据纳入标准筛选相关随机对照试验,评价研究质量后用RevMan 5.1软件进行分析,分析指标为有效率、临床获益率及不良反应.结果:共纳入12项研究,总病例数691例.Meta分析显示:沙利度胺联合化疗组在有效率(OR=1.62,95%CI:1.18~2.22)及临床获益率(OR=2.05,95%CI:1.40~3.02)方面优于单纯化疗组.联合治疗组与单纯化疗组相比,血液学毒性发生率差异无统计学意义,恶心呕吐发生率低于后者(P=0.002),外周神经毒性发生率有高于后者的趋势(P=0.05),而便秘、乏力嗜睡、皮疹或瘙痒发生率高于后者(P值分别为0.002、0.0002、0.001).结论:沙利度胺联合化疗可能提高中国患者的治疗有效率与临床获益率,但生存获益尚不明确.联合治疗不增加严重不良反应.
목적:통과Meta분석탐토사리도알연합화료재만기비소세포폐암환자중적응용개치.방법:유량위독립평개자안상동검색책략검색중국생물의학문헌고등자원중적문헌,근거납입표준사선상관수궤대조시험,평개연구질량후용RevMan 5.1연건진행분석,분석지표위유효솔、림상획익솔급불량반응.결과:공납입12항연구,총병례수691례.Meta분석현시:사리도알연합화료조재유효솔(OR=1.62,95%CI:1.18~2.22)급림상획익솔(OR=2.05,95%CI:1.40~3.02)방면우우단순화료조.연합치료조여단순화료조상비,혈액학독성발생솔차이무통계학의의,악심구토발생솔저우후자(P=0.002),외주신경독성발생솔유고우후자적추세(P=0.05),이편비、핍력기수、피진혹소양발생솔고우후자(P치분별위0.002、0.0002、0.001).결론:사리도알연합화료가능제고중국환자적치료유효솔여림상획익솔,단생존획익상불명학.연합치료불증가엄중불량반응.
Objective: To investigate the efficacy and adverse reactions of thalidomide-chemotherapy combination regimen in advanced Chinese non-small cell lung cancer patients by meta-analysis. Methods: Data of randomized controlled trials were collected from different databases by two independent researchers according to inclusion and exclusion criteria. Meta-analysis of the response rate, clinical benefit response, and different adverse reactions between the thalidomide-chemotherapy combination group and chemotherapy-only group was performed using RevMan 5.1 software. Results: A total of 691 patients in 12 randomized clinical trials were included. The meta- analysis results showed that the thalidomide-chemotherapy group had higher response rate [OR=1.62, 95%CI (1.18–2.22)] and clinical benefit response [OR = 2.05, 95% CI (1.40–3.02)] (P=0.003, P<0.001, respectively). In the thalidomide-chemotherapy group, the incidence of nausea and vomiting were statistically lower (P=0.002), but the incidence of constipation, somnolence, erythra, and peripheral neurotoxicity were statistically higher (P=0.002, 0.000 2, 0.001, and 0.05, respectively). The differences among the marrow suppression incidences were not statistically significant. Conclusion: Thalidomide addition to chemotherapy can improve the response rate and clinical benefit response of Chinese patients, but their overall survival remains to be explored. No serious adverse reaction was observed in the combination therapy group.