摘要
目的 采用Meta分析比较全脑放疗（WBRT）联合靶向药物与单用WBRT在非小细胞肺癌（NSCLC）脑转移瘤患者治疗中的疗效和安全性。方法 计算机检索Pubmed、Embase、中国知网、万方数据库中有关WBRT联合靶向药物治疗NSCLC脑转移的文献,检索时间均从建库至2016年5月。通过纽卡斯尔-渥太华量表（NOS）对文献进行质量评价,采用优势比（OR）及其95%可信区间合并效应量,采用Rev Man5.2软件进行数据分析。结果 最终纳入15篇研究文献,共计1 084例患者。结果显示：联合治疗组疾病控制率（OR：3.09,95%CI 2.11~4.54,P〈0.00001）、1年生存率（OR：2.55,95%CI 1.84~3.54,P〈0.00001）均高于单纯放疗组,差异具有明显统计学意义;安全性方面,联合治疗组皮疹发生率高于单纯放疗组（OR：9.10,95%CI 2.89~28.66,P=0.0002）,但均属于Ⅰ~Ⅱ度不良反应,经对症处理后可缓解,其余不良反应如腹泻、恶心呕吐、乏力、骨髓抑制、呼吸困难两组比较均无统计学意义（P〉0.05）。结论WBRT联合靶向药物治疗NSCLC脑转移瘤明显优于单纯WBRT放疗,不良反应亦无明显增加。
Objective To compare the efficacy and safety between whole brain radiotherapy（WBRT） combined with targeted therapy and WBRT alone in the treatment of non-small cell lung cancer（NSCLC） with brain metastasis by Meta analysis. Methods A literature search was conducted among PubMed, Embase, Wanfang and the Chinese National Knowledge Infrastructure databases which related WBRT plus target therapy or WBRT alone in the treatment of NSCLC with brain metastases from inception to May, 2016. Studies quality was assessed by Newcastle-Ottawa Scale（NOS）, odds ratios （OR） and 95% confidence intervals （Cls） as effect measures. The data analysis were performed using RevMan5.2. Results Fifteen eligible studies including 1 084 cases were included. Results showed that compared with WBRT alone, WBRT combined with targeted therapy showed higher disease control rate （ OR： 3.09, 95% CI 2.11-4. 54, P 〈 0.00001 ） and 1-year overall survival （OR： 2.55, 95% CI 1.84-3.54, P〈0.00001） , differences were statistical significance. In safety part, add targeted therapy were frequently had rash （OR： 9.10,95% CI 2.89-28.66, P = 0.0002）, but all of them were 1-2 grade toxicity and could be tolerated. There were no significant differences in Diarrhea, nausea, vomiting, fatigue, bone marrow suppression and dyspnea（P〉0.05）. Conclusion WBRT plus target therapy is superior to WBRT alone and well tolerated in the treatment of NSCLC with brain metastases. In addition, more high quality randomized controlled trials are needed.
出处
《中华肺部疾病杂志（电子版）》
CAS
2016年第4期366-371,共6页
Chinese Journal of Lung Diseases(Electronic Edition)
基金
国家自然科学基金资助项目(81271264)
关键词
非小细胞肺癌
脑转移
放疗
靶向治疗
META分析
Non-small cell lung cancer
Brain metastasis
Radiation therapy
Targeted therapy
Meta analysis
