| 许 斌,胡伟国,翁一鸣.EGFR-TKI联合化疗与单用化疗治疗晚期非小细胞肺癌有效性和安全性的Meta分析[J].肿瘤学杂志,2017,23(11):978-986. |
| EGFR-TKI联合化疗与单用化疗治疗晚期非小细胞肺癌有效性和安全性的Meta分析 |
| Efficacy and Safety of Chemotherapy Plus EGFR-TKI versus Chemotherapy Alone in Advanced Non-Small Cell Lung Cancer：Ａ Meta-analysis |
| 投稿时间：2017-03-31 |
| DOI：10.11735/j.issn.1671-170X.2017.11.B008 |
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| 中文关键词: EGFR-TKI 化疗 非小细胞肺癌 Meta分析 |
| 英文关键词:EGFR-TKI chemotherapy NSCLC meta-analysis |
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| 摘要点击次数: 1888 |
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| 中文摘要: |
| 摘 要：［目的］ 系统评价表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitors，EGFR-TKI)联合化疗与单用化疗治疗晚期非小细胞肺癌有效性和安全性。［方法］ 计算机系统检索、搜集EGFR-TKI联合化疗对比单用化疗药治疗晚期NSCLC的相关随机对照试验(randomized controlled trails，RCTs)。提取客观反应率(objective response rate，ORR)、无进展生存期(progression-free survival，PFS)、总生存期(overall survival，OS)和不良反应(adverse events，AEs)等数据。［结果］ 共纳入15项研究。与单用化疗相比，EGFR-TKI联合化疗可显著提升晚期NSCLC患者的PFS(HR=0.73，95%CI：0.62~0.86，P=0.0002)，并有延长OS 的趋势(HR=0.92，95%CI：0.86~1.00，P=0.05)。EGFR-TKI联合化疗的间插给药方式可显著性提升晚期NSCLC患者的PFS(HR=0.59，95%CI：0.51~0.68，Ｐ<0.00001)和OS (HR=0.84，95%CI：0.72~0.99，Ｐ=0.03)。此外，在EGFR敏感突变的患者中，EGFR-TKI联合化疗与单用化疗相比可显著性延长PFS(HR=0.38，95%CI：0.17~0.87，Ｐ=0.02)和OS (HR=0.45，95%CI：0.27~0.75，Ｐ=0.002)。［结论］ EGFR-TKI联合标准化疗是EGFR敏感突变的晚期NSCLC患者的一种极具潜力的治疗方案。此外，间插的治疗方式较同步的治疗方式更好，值得临床推广。 |
| 英文摘要: |
| Abstract：［Objective］ To compare epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI) plus chemotherapy with chemotherapy alone in treatment of advanced non-small cell lung cancer(NSCLC). ［Methods］ The randomized controlled trials(RCTs) that compared EGFR-TKI plus standard chemotherapy with chemotherapy alone in treatment of advanced non-small cell lung cancer(NSCLC) patients were searched and meta-analysis was performed. Objective response rate(ORR)，progression-free survival(PFS)，overall survival(OS) and adverse events(AEs) of two therapeutic methods were compared. ［Results］ Fifteen trials were included. Compared with chemotherapy alone，there was significant improvement in PFS(HR=0.73，95%CI：0.62~0.86，P=0.0002) and a tendency to prolong OS(HR=0.92，95%CI：0.86~1.00，P=0.05) in advanced NSCLC patients who used EGFR-TKI plus standard chemotherapy; and intercalated EGFR-TKI plus chemotherapy significantly improved the PFS(HR=0.59，95%CI：0.51~0.68，P<0.00001) and OS(HR=0.84，95%CI：0.72~0.99，P=0.03). Further，in those patients with EGFR sensitive mutations，compared with chemotherapy alone，EGFR-TKI plus standard chemotherapy significantly improved the PFS(HR=0.38，95%CI：0.17~0.87，P=0.02) and OS(HR=0.45，95%CI：0.27~0.75，P=0.002). ［Conclusion］ EGFR-TKI plus standard chemotherapy is a promising treatment alternative for advanced NSCLC patients with EGFR mutations; and the intercalated therapy is better than continuous therapy. |
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