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目的:采用Meta分析方法评价伊立替康联合铂类一线治疗广泛期小细胞肺癌的临床疗效和安全性。方法:计算机检索中国期刊全文数据库(CNKI)、万方数据库、中国生物医学文献数据库(Sino Med)、Pub Med、the Cochrane Library和Embase中有关伊立替康联合铂类对比依托泊苷联合铂类治疗广泛期小细胞肺癌的RCTs,对纳入文献进行质量评价,提取资料并通过Rev Man 5.3软件进行数据分析。结果:共纳入7篇文献,累计1 881例受试者。Meta分析显示:伊立替康联合铂类一线治疗广泛期小细胞肺癌的疗效要优于依托泊苷联合铂类,可提高患者的2年总生存率(RR=1.19,95%CI:1.06~1.34,P=0.003),但是伊立替康联合铂类会增加化疗所致3~4度腹泻不良反应的发生率(RR=8.03,95%CI:3.18~20.27,P<0.000 01)。结论:伊立替康联合铂类一线治疗广泛期小细胞肺癌具有良好的疗效,但仍需警惕其不良反应。
OBJECTIVE: To evaluate the clinical efficacy and safety of irinotecan plus platinum first-line in the treatment of extensive-stage small cell lung cancer using Meta-analysis. Methods: The clinical data of patients with irinotecan plus platinum and etoposide combined with platinum on CNKI, Wanfang database, Sino Med, Pub Med, the Cochrane Library and Embase Extensive stage small cell lung cancer RCTs were included in the literature for quality evaluation, data were extracted and analyzed by Rev Man 5.3 software. Results: A total of 7 articles were included, with a total of 1,881 subjects. Meta-analysis showed that irinotecan combined with platinum first-line treatment of extensive-stage small cell lung cancer is superior to etoposide combined with platinum, can improve the 2-year overall survival (RR = 1.19, 95% CI: 1.06 to 1.34 , P = 0.003). However, the combination of irinotecan and platinum increased the incidence of 3-4 degrees of chemotherapy-induced diarrhea (RR = 8.03, 95% CI: 3.18-20.27, P <0.000 01). Conclusion: The combination of irinotecan and platinum first-line therapy has a good curative effect in the treatment of extensive-stage small cell lung cancer, but its adverse reaction needs to be observed.