吉西他滨联合铂类两药方案与单药方案对非小细胞肺癌治疗比较的meta分析

BACKGROUND AND OBJECTIVE: Whether gemcitabine plus platinum chemotherapy is superior to gemcitabine or platinum single-agent chemotherapy for patients with non-small cell lung cancer (NSCLC) is still in dispute, and the aim of this study is to evaluate the efficacy and safety of gemcitabine combining platinum chemotherapy for patients with NSCLC. METHODS: We searched relevant randomized controlled trials (RCTs) from VIP, CBM, CNKI, the Cochrane library, PUBMED and EMBASE. We traced the related references and experts in this field and communicated with other authors to obtain the information that has not been found. We made quality assessment of qualified RCTs assessed by the exclusion and inclusion criteria and used RevMan 5.0 provided by the Cochrane Collaboration to perform meta-analysis. RESULTS: Four RCTs were eligible and included 984 patients. Meta analysis results suggested that: compared with gecitabine single-agent chemotherapy, the combination had a statistically significant benefit in increasing the response rate (OR=3.29, 95%CI: 1.79-6.05, P=0.000 1) and 2-year survival rate (OR=3.22, 95%CI: 1.45-7.12, P=0.004) while increased the risk of the incidence of adverse reactions, especially the grade 3-4 thrombocytopenia (RR=8.16, 95%CI: 1.71-39.07, P=0.009); compared with cisplatin single-agent chemotherapy, the combination had a statistically significant benefit in increasing the response rate (OR=3.51, 95%CI: 2.20-5.60, P < 0.01) and 1-year survival rate (OR=1.67, 95%CI: 1.16-2.41, P=0.006) while increased the risk of the incidence of adverse reactions, especially the grade 3-4 thrombocytopenia (OR=28.55, 95%CI: 14.06-57.04, P < 0.01). CONCLUSION: Compared with single-agent chemotherapy, the combining can significantly improve the efficiency and survival rate while increase the toxicity rare. The results still need to be proved by high quality RCTs.