作　　者： (刘爱华）; (张明）;

机构地区： 中国医科大学附属第一医院内分泌科,辽宁沈阳110001

出　　处： 《沈阳药科大学学报》 2017年第8期694-700,共7页

摘　　要： 目的系统评价培美曲塞联合卡铂(pemetrexed plus carboplatin,PC)方案与吉西他滨联合卡铂(gemcitabine plus carboplatin,GC)方案治疗非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效性及安全性。方法计算机检索Pub Med,Cochrane Library,Embase,万方,中国知网和维普数据库中关于PC方案对比GC方案治疗非小细胞肺癌的随机对照临床试验(randomized controlled trials,RCTs)。采用Stata12.0软件对符合标准的RCTs进行Meta分析。结果共纳入9篇RCTs,674例患者。Meta分析结果显示PC方案与GC方案相比治疗有效率差异无统计学意义(OR=0.963,95%CI:0.611-1.314,P=0.907);PC方案相较于GC方案可显著降低白细胞减少发生率(OR=0.287,95%CI:0.120-0.453,P=0.000)、血小板减少发生率(OR=0.184,95%CI:0.074-0.295,P=0.000)、恶心呕吐发生率(OR=0.272,95%CI:0.114-0.430,P=0.000)以及脱发发生率(OR=0.435,95%CI:0.123-0.747,P=0.034)。结论 PC方案与GC方案治疗NSCLC患者的有效率相似,但PC方案的毒副作用发生率低于GC方案。 Objective To compare the efficacy and safety of pemetrexed plus carboplatin （PC） and gemcitabine plus carboplatin （GC） in the treatment of advanced non-small cell lung cancer （NSCLC）. Methods PubMed, the Cochrane Library, Embase, WanFang database, CNKI and VIP were systematically searched for randomized controlled trials to assess the efficacy and safety of PC and GC chemotherapy for NSCLC. Statal2.0 software were used for meta-analysis. Results In the analysis of 9 randomized trials, which involved 674 patients, no significant difference between PC and GC was found in effective rate （OR = 0. 963,95 % CI：0. 611 - 1.314, P = 0. 907 ）. However, PC was associated with a more significant decrease in the incidence of leucocytopenia （OR = 0.287,95% CI： 0. 120 - 0.453, P = 0.000）, thrombocytopenia （ OR = 0. 184,95 % CI： 0. 074 - 0. 295, P = 0. 000 ）, nausea and vomit （ OR = 0. 272,95 % CI：0. 114 -0. 430 ,P =0. 000） and lipsotrichia （OR =0. 435,95% CI：0. 123 -0. 747 ,P =0. 034）. Conclu- sions PC and GC for NSCLC have similar effect,but PC has a lower incidence of side effects than GC.

关 键 词： 非小细胞肺癌 培美曲塞 吉西他滨 卡铂 分析