中国肺癌杂志2016，Vol.19Issue(12)：837-846,10.DOI:10.3779/j.issn.1009-3419.2016.12.06
化疗间插联合EGFR-TKIs对比单独化疗一线治疗晚期非小细胞肺癌的meta分析
Intercalated Combination of Chemotherapy and EGFR-TKIs versus Chemotherapy Alone in the First-line Treatment of Advanced Non-small Cell Lung Cancer：A Meta-analysis
摘要
Abstract
Background and objective The combination therapy of chemotherapy and epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has attracted the attention of more and more investigators. The aim of this meta-analysis is to evaluate the clinical effcacy and safety of intercalated combination of chemotherapy and EGFR- TKIs versus chemotherapy alone in the ifrst-line therapy of advanced non-small cell lung cancer (NSCLC).Methods We retrieved the Co-chrane Library, PubMed, EMBASE, CBM, CNKI and Wanfang databases for randomized controlled trials which involved the intercalated combination of chemotherapy and EGFR-TKIs, and chemotherapy alone in the first-line treatment of advanced NSCLC. hTe progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse events were analyzed. hTe quality evaluation and cross-checked data were independently performed by two in-vestigators according to the Cochrane Systematic Reviews Handbook. hTe Stata 12.0 sotfware was used to conduct themeta-analysis.Results This study included 933 NSCLC patients from 6 RCTs. Themeta-analysis demonstrated that the intercalated combination of chemotherapy and EGFR-TKIs signiifcantly prolonged the PFS (HR=0.72, 95% CI: 0.53-0.98,P=0.037) of advanced NSCLC patients compared with mono-chemotherapy. However, there was no statistical difference in OS (HR=0.85, 95%CI: 0.72-1.01,P=0.060), ORR (OR=1.59, 95%CI: 0.86-2.95,P=0.142) and DCR (OR=1.09, 95% CI: 0.95-1.25,P=0.226) between the two groups. Further, the subgroup analysis showed that the intercalated combination markedly improved the PFS in female, adenocarcinoma, never smoking,EGFR mutant patients. In the aspect of safety, the main side effects of the interca-lated combination therapy were rash (OR=7.81, 95%CI: 3.74-16.34,P<0.001) and diarrhea (OR=2.73, 95% CI: 1.92-3.89, P<0.001).Conclusion hTe intercalated combination of chemotherapy and EGFR-TKIs signiifcantly prolonged the PFS in the first-line therapy of advanced NSCLC patients compared with mono-chemotherapy, and the main adverse events were toler-able rash and diarrhea. Together, the intercalated combination shows promising results, and more large-scale and high-quality RCTs are still needed.关键词
肺肿瘤/化疗/表皮生长因子受体酪氨酸激酶抑制剂/间插联合疗法/一线治疗/Meta分析Key words
Lung neoplasms/Chemotherapy/Epidermal growth factor receptor-tyrosine kinase inhibitors/Inter-calated combination/First-line treatment/Meta-analysis引用本文复制引用
洪超煜,梅同华,王进..化疗间插联合EGFR-TKIs对比单独化疗一线治疗晚期非小细胞肺癌的meta分析[J].中国肺癌杂志,2016,19(12):837-846,10.基金项目
本研究受江西省科技支撑计划项目（No.20121BBG70053）资助@@@@ This study was supported by the grant from the Science-technology Support Plan Project of Jiangxi Province (to Ton-ghua MEI)(No.20121BBG70053) （to Ton-ghua MEI）
