摘要
目的 采用meta分析方法评价免疫检查点抑制剂(ICI)联合疗法治疗小细胞肺癌(SCLC)的疗效及安全性。方法 检索PubMed、ASCO Abstract、EMBase、Cochrane Library、知网、维普、万方等数据库,检索有关ICI联合疗法治疗SCLC的随机对照试验(RCT),由2名研究者按纳入、排除标准进行文献筛选、资料提取及纳入研究的方法学质量评价。采用RevMan 5.3软件进行meta分析。结果 最终纳入5项RCTs,包含2 508例患者。结果显示,与单独治疗组相比,ICI联合疗法可延长SCLC患者的无进展生存期及总生存期(HR=0.86,95%CI 0.79~0.93,P=0.000 4;HR=0.85,95%CI 0.74~0.99,P=0.04)。ICI联合疗法未能增加SCLC的缓解率(HR=0.03,95%CI-0.03~0.10,P=0.05)。在≥3级不良反应方面,与单独治疗组比较,ICI联合疗法中性粒细胞减少、白细胞减少、血小板减少、贫血发生率降低,但腹泻、食欲下降、疲劳、皮疹、肝功能受损发生率升高,差异均有统计学意义(P<0.05)。2组恶心、脱发事件的发生率比较,差异无统计学意义(P>0.05)。结论 ICI联合疗法能够延长晚期SCLC患者的总生存期、无进展生存期,但增加了部分不良反应的发生。
Objective To evaluate the efficacy and safety of immune checkpoint inhibitor(ICI)combination therapy in the treatment of small cell lung cancer(SCLC)using meta-analysis.Methods PubMed,American Society of Clinical Oncology(ASCO)Abstract,EMBase,Cochrane Library,China National Knowledge Infrastructure(CNKI),Vip and Wanfang databases were searched for the randomized controlled trials(RCTs)on the ICI combination therapy for SCLC.Literature screening,data extraction and methodological quality evaluation of the included studies were performed by two investigators according to the inclusion and exclusion criteria.RevMan 5.3 software was used to perform the meta-analysis.Results A total of five RCTs containing 2508 patients were eventually included.The results showed that the ICI combination therapy could prolong progression-free survival and overall survival of SCLC patients compared to that of the treatment alone group(HR=0.86,95%CI 0.79-0.93,P=0.0004;HR=0.85,95%CI 0.74-0.99,P=0.04).In contrast,the ICI combination therapy failed to increase the remission rate of SCLC(HR=0.03,95%CI-0.03-0.10,P=0.05).In the≥3 adverse reactions,the ICI combination therapy could reduce the incidence rates of neutropenia,leukopenia,thrombocytopenia and anemia.However,it could increase the incidence rates of diarrhoea,decreased appetite,fatigue,rash,and impaired liver function.The incidence rates of nausea and hair loss events were not statistically different(P>0.05).Conclusion The ICI combination therapy can prolong the overall survival and progression-free survival of the patients with advanced SCLC.However,it can increase the occurrence of some adverse events.
作者
万秋
王敏
唐莉歆
WAN Qiu;WANG Min;TANG Lixin(Chongqing Public Health Medical Center,Chongqing 400030,China)
出处
《现代医药卫生》
2022年第7期1150-1154,共5页
Journal of Modern Medicine & Health
关键词
免疫检查点抑制剂
小细胞肺癌
联合疗法
META分析
Immune checkpoint inhibitor
Small cell lung cancer
Combination therapy
Meta analysis
