摘要
目的评价培美曲塞联合顺铂治疗中晚期肺腺癌的有效性和临床研究质量。方法在中国期刊全文数据库（CNKI），中国生物医学文献数据库（CBM）、中文科技期刊数据库（CSTJ）、万方数据库、PubMed、荷兰医学文摘数据库（EMBASE）及Cochrane中心临床对照试验资料库（CENTRAL）检索从2010年3月至2014年3月关于培美曲塞联合顺铂治疗中晚期肺腺癌随机对照试验的文献，并用RevMan5．0进行Meta分析。结果共纳入10篇研究，437例患者。其中培美曲塞联合顺铂组（试验组）217例，多西他赛联合顺铂组（对照组）220例。Meta分析显示：试验组的近期有效率明显高于对照组[比值比（OR）=1．77，95％置信区间（CI）：1．18～2．64，P=0．006]，试验组白细胞减少发生率低于对照组（OR=0．31，95％CI：0．19—0．51，P〈0．00001），试验组的血小板减少发生率小于对照组，差异有统计学意义（OR=0．26，95％CI：0．12—0．59，P=0．001）。2组血红蛋白减少发生率差异无统计学意义（OR=0．70，95％CI：0．35～1．38，P=0．300）。结论培美曲塞联合顺铂治疗中晚期肺腺癌不仅疗效优于多西他赛联合顺铂，且可降低不良反应发生率。
Objective To assess the effect of pemetrexed combined with cisplatin in treatment of advanced lung adenoearcinoma. Methods The China National Knowledge Infrastructure （ CNKI ）, Chinese Bio medical Literature Database （CBM） , China Science and Technology Journal Database （CSTJ） , Wanfang Database, PubMed, Exeerpta Medica Database （EMBASE） and Cochrane Central Register of Controlled Trials （CENTRAL） were searched from March 2010 to March 2014 to get the randomized controlled trials of pemetrexed combined with cisplatin treating advanced lung adenocareinoma, and the Meta-analysis was conducted with RevMan 5.0. ResultsTen randomized controlled trials were included in the systematic review with 437 patients. Among them, the pemetrexed combined with cisplatin for the treatment group included 217 patients; the docetaxel combined with eisplatin included 220 patients. According to the Meta analysis, 10 studies showed that the effective rate of short-term treatment with pemetrexed combined with cisplatin for the experimental group was improved compared to the control group; the odds risk（OR） and 95% confidence interval （CI） was 1.77 （1. 18-2.64） （ P = 0.006）. Eight studies showed that in terms of reducing white blood cells, pemetrexed combined with eispla- tin reduced the white cell account （ OR =0.31,95% CI： 0. 19-0.51 ,P 〈0. 000 01 ）. 7 studies showed that pemetrexed combined with cisplatin reduced the account of platelet （ OR = 0.26, 95% CI： 0. 12-0.59, P = 0. 001 ）. While in aspect of decreasing hemoglobin, it was not statistically significant between the two groups （ OR = 0.70, 95% CI： 0. 35-0.1. 38, P = 0.30 ）. Conclusions The results of systematic review indicate that compared with docetaxel combined with cisplatin, pemetrexed combined with cisplatin not only can improve the effective rate of short-term treatment, but also can reduce adverse reactions.
出处
《中国医药》
2015年第3期335-339,共5页
China Medicine
