培美曲塞与多西紫杉醇比较治疗晚期非小细胞肺癌的Meta分析
Pemetrexed versus Docetaxel for Advanced Non-Small-Cell Lung Cancer:A Meta-analysis
查看参考文献21篇
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文摘
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目的系统评价培美曲塞与多西紫杉醇治疗晚期非小细胞肺癌(NSCLC)的疗效与安全性。方法计算机检索Cochrane Library、PubMed、EMbase、SCI、CBM、CNKI和VIP,同时辅助其他检索方式,纳入培美曲塞与多西紫杉醇比较治疗晚期非小细胞肺癌的临床随机对照试验,检索时间截至2010年11月。由两位研究者独立进行文献筛选、资料提取和方法学质量评价后,采用RevMan5.0软件进行Meta分析。结果共纳入5个研究,合计847例患者。Meta分析结果显示:在疗效方面,培美曲塞与多西紫杉醇相比,两者在有效率[OR=1.09,95%CI(0.7,1.70)]、疾病控制率[OR=0.99,95%CI(0.75,1.31)]、1年生存率[OR=1.11,95%CI(0.56,2.18)]等方面差异无统计学意义;在安全性方面,与多西紫杉醇相比,培美曲塞可降低中性粒细胞减少[OR=0.09,95%CI(0.05,0.15)]和粒细胞性发热[OR=0.13,95%CI(0.06,0.29)]、减少脱发[OR=0.20,95%CI(0.12,0.33)],而在血红蛋白[OR=1.45,95%CI(0.23,9.06)]、血小板减少[OR=1.46,95%CI(0.59,3.59)]、恶心呕吐[OR=1.23,95%CI(0.53,2.83)]、疲劳乏力[OR=0.73,95%CI(0.40,1.30)]等方面两者差异无统计学意义。结论当前证据显示,培美曲塞与多西紫杉醇治疗晚期NSCLC的疗效相当,但可减少中性粒细胞减少、粒细胞性发热和脱发等不良反应。 |
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其他语种文摘
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Objective For the dispute on the superiority of the pemetrexed compared with the docetaxel for treating advanced non-small-cell lung cancer(NSCLC),this study is conducted to evaluate the efficacy and safety of pemetrexed versus docetaxel for patients with NSCLC.Methods Such databases as The Cochrane Library,PubMed,EMBASE,SCI,CBM,CNKI,and VIP were searched to collect the randomized controlled trials(RCTs)about pemetrexed versus docetaxel for the treatment of NSCLC published before November of 2010.Two reviewers independently screened the studies,extracted the data and assessed the methodology quality.RevMan 5.0 software was used for meta-analyses.Results Five studies involving 847 patients were included.The results of meta-analyses showed that,in the aspect of efficacy,there was no significant difference between the two groups in the effective rate(OR=1.09,95%CI 0.7 to 1.70),the disease control rate(OR=0.99,95%CI 0.75 to 1.31),and the one-year survival rate(OR=1.11,95%CI 0.56 to 2.18);in the aspect of safety,compared with docetaxel,pemetrexed could reduce the neutropenia(OR=0.09,95%CI 0.05 to 0.15),the febrile neutropenia(OR=0.13,95%CI 0.06 to 0.29)and the alopecia(OR=0.20,95%CI 0.12 to 0.33),but no significant difference was found in haemoglobin(OR=1.45,95%CI 0.23 to 9.06),thrombocytopenia(OR=1.46,95%CI 0.59 to 3.59),nausea and vomiting(OR=1.23,95%CI 0.53 to 2.83)and fatigue and debilitation(OR=0.73,95%CI 0.40 to 1.30).Conclusion?As the current evidence shows,pemetrexed has similar efficacy to docetaxel for advanced NSCLC patients,but it has fewer side effects of neutropenia,febrile neutropenia and alopecia |
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来源
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中国循证医学杂志
,2011,11(8):960-964 【扩展库】
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关键词
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培美曲塞
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多西紫杉醇
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晚期非小细胞肺癌
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系统评价
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Meta分析
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随机对照试验
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地址
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兰州大学循证医学中心, 兰州, 730000
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语种
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中文 |
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文献类型
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研究性论文 |
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ISSN
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1672-2531 |
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学科
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肿瘤学 |
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基金
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兰州大学2010教学研究项目
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兰州大学循证医学中心循证医学创新项目
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文献收藏号
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CSCD:4287727
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参考文献 共
21
共2页
|
|
1.
.
National Cancer Institute SEER data,2009
|
CSCD被引
1
次
|
|
|
|
|
2.
Novello S. Chemotherapy for non-small-cell lung cancer.Part 1:Early-stage disease.
Oncology (Williston Park),2003,17(3):357-364
|
CSCD被引
4
次
|
|
|
|
|
3.
Socinski MA. Chemotherapeutic Managenment of StageⅣNon-small Cell Lung Cancer.
Chest,2003,123(1 Suppl):226S-243S
|
CSCD被引
8
次
|
|
|
|
|
4.
Di Maio M. Meta-analysis of single-agent chemotherapy compared with combination chemotherapy as second line treatment of advanced non-small-cell lung cancer.
J Clin Oncol,2009,27(11):1836-1843
|
CSCD被引
6
次
|
|
|
|
|
5.
NCCN非小细胞肺癌临床实践指南专家组.
肿瘤学临床实践指南(中国版).第1版,2008:20-21
|
CSCD被引
1
次
|
|
|
|
|
6.
Ciuleanu T. Maintenance pemetrexed plus best supportive care versus placebo plus best supportive care for non-small-cell lung cancer:a randomised,double-blind,phase 3 study.
Lancet,2009,374(9699):1432-1440
|
CSCD被引
70
次
|
|
|
|
|
7.
母连军. 培美曲塞获准作为非小细胞肺癌治疗的一线药.
国外医药抗生素分册,2008,29(6):285-286
|
CSCD被引
2
次
|
|
|
|
|
8.
刘宝. 4种非小细胞肺癌二线药物治疗方案费用比较研究.
中国药房,2010,21(26):2303-2406
|
CSCD被引
1
次
|
|
|
|
|
9.
Higgins JPT.
Assessing risk of bias in included studies.Cochrane Handbook for Systematic Review of Inerventions Version5.0.0(update February 2008).e Cochrane Collaboration,2008
|
CSCD被引
1
次
|
|
|
|
|
10.
陈墨. 力比泰与泰素帝治疗非小细胞肺癌临床疗比较.
同济大学(医学版),2008,29(3):54-57
|
CSCD被引
1
次
|
|
|
|
|
11.
胡广原. 培美曲塞二钠单药对比多西紫杉醇二线治疗晚期非小细胞肺癌临床观察.
临床荟萃,2009,24(13):1166-1168
|
CSCD被引
2
次
|
|
|
|
|
12.
孟丽娟. 老年晚期非小细胞肺癌单药二线培美曲塞或多西他赛治疗的临床观察.
实用老年医学,2010,24(1):66-68
|
CSCD被引
2
次
|
|
|
|
|
13.
冯永. 培美曲塞,多西紫杉醇治疗晚期非小细胞肺癌的疗效比较.
山东医药,2010,50(37):53-54
|
CSCD被引
4
次
|
|
|
|
|
14.
Hanna N. Randomized PhaseⅢ Trial of Pemetrexed Versus Docetaxel in Patients With Non-Small-Cell Lung Cancer Previously Treated With Chemotherapy.
J Clin Oncol,2004,22(9):1589-1597
|
CSCD被引
126
次
|
|
|
|
|
15.
Shepherd FA. prospective randomized trial of docetaxel versus best supportive care in patients with nonsmall cell lung cancer previously treated with platinum-based chemotherapy.
J Clin Oncol,2000,18(10):2095-2103
|
CSCD被引
78
次
|
|
|
|
|
16.
Fossella F. Randomized phaseⅢtrial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small cell lung cancer previously treated with platinum-containing chemotherapy regimens e TAX 320 Non-Small Cell Lung Cancer Study Group.
J Clin Oncol,2000,18(12):2354-2362
|
CSCD被引
2
次
|
|
|
|
|
17.
郭荣荣. 多西紫杉醇作为晚期非小细胞肺癌的二线治疗药物的系统评价.
中国循证医学杂志,2008,8(10):861-868
|
CSCD被引
4
次
|
|
|
|
|
18.
Calvert H. An overview of folate metabolism:features relevant to the action and toxicities of antifolate anticancer agents.
Semin Oncol,1999,26(2 Suppl 6):3-10
|
CSCD被引
9
次
|
|
|
|
|
19.
Adjei AA. Pharmacology and mechanism of action of pemetrexed.
Clin lung cancer,2004,5(Suppl 2):S51-S55
|
CSCD被引
8
次
|
|
|
|
|
20.
Weiss GJ. Elderly Patients Benefit From Second-Line Cytotoxic Chemotherapy:A Subset Analysis of a Randomized Phase III Trial of Pemetrexed Compared With Docetaxel in Patients With Previously Treated Advanced Non–Small-Cell Lung Cancer.
J Clin Oncol,2006,24(27):4405-4411
|
CSCD被引
13
次
|
|
|
|
|
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