摘要
目的:探讨斑蝥酸钠联合常规化疗治疗非小细胞肺癌(NSCLC)的临床疗效和安全性,为临床用药提供循证参考。方法:计算机检索中国知网(CNKI)、万方数据库、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Embase、Web of Science、Cochrane Library,并补充检索临床试验注册库National Library of Medicine、中国临床试验注册中心,检索时间均为建库至2023年6月,收集斑蝥酸钠联合常规化疗治疗NSCLC患者的随机对照试验文献。通过Cochrane系统评价手册5.1.0版进行文献质量评价,并采用RevMan 5.3软件进行Meta分析。结果:本研究共检索出251篇文献,最终纳入28篇文献,共计2167例患者,其中对照组(常规化疗)1077例,联合组(斑蝥酸钠联合常规化疗)1090例。Meta分析结果显示,联合组患者ORR[RR=1.47,95%CI(1.31,1.64),P<0.00001]和DCR[RR=1.14,95%CI(1.09,1.20),P<0.00001]均高于对照组。联合组患者生活质量的改善效果优于对照组[RR=1.76,95%CI(1.51,2.04),P<0.00001]。联合组患者白细胞减少[OR=0.32,95%CI(0.25,0.41),P<0.00001]、胃肠道反应[OR=0.39,95%CI(0.30,0.52),P<0.00001]、血小板减少[OR=0.48,95%CI(0.25,0.94),P=0.03]的发生率均低于对照组。结论:斑蝥酸钠联合常规化疗可显著提高NSCLC患者的治疗有效率,改善患者生活质量,且能降低血液毒性、胃肠道反应的发生风险。
Objective:To explore the clinical efficacy and safety of disodium cantharidinate combined with conventional chemotherapy in the treatment of non-small cell lung carcinoma(NSCLC),so as to provide evidence-based reference for clinical medication.Methods:Databases,including CNKI,Wanfang Database,VIP,CBM,PubMed,Embase,Web of Science and Cochrane Library,as well as National Library of Medicine and Chinese Clinical Trial Registry were searched with the search time from the time of database establishment to June 2023 in order to collect literature about randomized controlled trials of disodium cantharidinate combined with conventional chemotherapy in NSCLC patients.Literature quality was evaluated by Cochrane manual of systematic review 5.1.0,and Meta-analysis was performed using RevMan 5.3 software.Results:A total of 251 articles were retrieved,and 28 articles were finally included,with a total of 2167 patients,including 1077 patients in the control group(conventional chemotherapy)and 1090 patients in the combination group(disodium cantharidinate combined with conventional chemotherapy).Meta-analysis showed that ORR[RR=1.47,95%CI(1.31,1.64),P<0.00001]and DCR[RR=1.14,95%CI(1.09,1.20),P<0.00001]in the combination group were higher than those in the control group.The improvement in quality of life in the combination group was superior to the control group[RR=1.76,95%CI(1.51,2.04),P<0.00001].The incidences of leucopenia[OR=0.32,95%CI(0.25,0.41),P<0.00001],gastrointestinal reaction[OR=0.39,95%CI(0.30,0.52),P<0.00001]and thrombocyto-penia[OR=0.48,95%CI(0.25,0.94),P=0.03]were lower in the combination group compared with the control group.Conclusion:Disodium cantharidinate combined with conventional chemotherapy can significantly improve the response rate in NSCLC patients,improve the quality of life,and reduce the risks of hematological toxicity and gastrointestinal reactions.
作者
菅若男
赵秀梅
吕志如
杨蕾
JIAN Ruo-nan;ZHAO Xiu-mei;LV Zhi-ru;YANG Lei(Department of Pharmacy,Hohhot First Hospital,Hohhot 010030,China)
出处
《中国合理用药探索》
CAS
2024年第10期43-51,共9页
Chinese Journal of Rational Drug Use
基金
内蒙古自治区首府地区公立医院高水平临床专科建设科技项目(2024SGGZ137)
呼和浩特市第一医院院级科研项目(2022SY053)。
关键词
斑蝥酸钠
非小细胞肺癌
META分析
随机对照试验
安全性
disodium cantharidinate
non-small cell lung carcinoma
Meta-analysis
randomized controlled trial
safety
