摘要
目的本研究系统评价唑来膦酸联合化疗与单纯化疗比较治疗非小细胞肺癌骨转移的临床疗效和安全性。方法计算机检索PubMed、The Cochrane Library、Embase、VIP、万方、CNKI和CBM等数据库,查找应用唑来膦酸联合化疗与单纯化疗比较治疗非小细胞肺癌骨转移的随机对照试验,检索时限从建库至2013年3月。由2位研究者按照纳入与排除标准独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.0.2软件进行Meta分析。结果纳入14个RCT,共1 184例患者。Meta分析结果显示,与单纯化疗比较,唑来膦酸联合化疗可以提高肺癌骨转移控制疼痛有效率[OR=5.78,95%CI:(3.93,8.51),P<0.00001]和骨病灶控制率[OR=5.82,95%CI:(3.52,9.61),P<0.00001],延迟骨相关事件发生率,但在肺部原发病灶控制率[OR=1.61,95%CI:(0.92,2.82),P=0.09]方面,两组差异无统计学意义;在不良反应方面,唑来膦酸联合化疗组发热、胃肠道反应、肌肉酸痛发生率均较单纯化疗组增多(P<0.05)。而一过性骨痛[OR=3.13,95%CI:(0.73,13.38),P=0.12]方面,两组差异无统计学意义。结论唑来膦酸联合化疗可以明显提高晚期非小细胞肺癌骨转移患者的控制疼痛有效率、骨病灶控制率、延迟骨相关事件发生,且其安全性尚可。
Objective To evaluate the efficacy and safety of zoledronic acid combined with chemotherapy versus chemotherapy alone for non-small cell lung cancer （NSCLC） patients with bone metastasis. Methods The randomized controlled trials （RCTs） about zoledronic acid plus chemotherapy vs chemotherapy alone for advanced NSCLC with bone metastasis were searched in PubMed, the Cochrane Library, Embase, VIP, Wanfang, CNKI, CBM and other electronic databases from inception to December 2011. Two reviewers screened studies according to inclusion and exclusion criteria, extracted data and assessed quality of the included studies independently. Then meta-analyses were performed using RevMan 5.0.2. Results A total of 14 RCTs of 1 184 cases were included. The results of meta-analyses showed that compared with the chemotherapy group, the combined group improved the rates of pain control [ OR = 5.78,95 % CI： （ 3.93,8.51 ） , P 〈0. 00001 ] and bone metastasis control [ OR = 5. 82,95% CI： （ 3.52,9.61 ）, P 〈0. 00001 ], there were no significantdifferences in primary lung lesion control [ OR = 1.61,95 % CI： （0.92,2.82） ,P = 0.091- The adverse reaction rates of the combined group, such as fever, gastrointestinal reactions and muscle soreness, were higher （ all P 〈 0.05 ）. Conclusion Zoledronic acid combined with chemotherapy can improve the rates of pain control and bone metastasis control for advanced NSCLC patients with bone metastasis, and the safety is acceptable.
出处
《实用肿瘤杂志》
CAS
2014年第1期55-61,共7页
Journal of Practical Oncology
基金
重离子等射线治疗肿瘤研究科技创新团队建设计划(098TTCA009)
兰州大学循证医学中心"循证医学研究生创新基金(2012LDEBM-A)"
关键词
癌
非小细胞肺
唑来膦酸
治疗应用
药物疗法
综合分析
随机对照试验
肿瘤转移
carcinoma, non-small cell lung
zoledronic acid/therapeutic use
drug therapy
Meta-analysis
randomized controlled trials
neoplasm metastasis
