用药指南
XU Huilin;GE Wei;CAO Dedong;MING Pingpo;ZHENG Yongfa;SONG Jing;LUO Wei
2014, 33(9): 1237-1242.
ObjectiveTo evaluate the effectiveness and safety of recombinant human endostatin combined with concurrent chemoradiotherapy versus concurrent chemoradiotherapy for advanced non small cell lung cancer (NSCLC).MethodsElectronic databases including the Cochrane library,PubMed,the Chinese biomedical literature database,China national knowledge internet(,EMbase,VIP and Wanfang database system were searched,until August,2013.The inclusion criteria was efficacy and safety studies of randomized controlled clinical studies in which recombinant human endostatin combined with concurrent chemoradiotherapy was compared with concurrent chemoradiotherapy alone for patients with advanced NSCLC.Cochrane handbook 5.1.0 was applied in evaluating the quality of included trials and RevMan 5.1.0 software was used for data analysis.ResultsFive studies including 217 cases of advanced NSCLC were included.The results of the metaanalysis exhibited that compared with concurrent chemoradiotherapy alone,recombinant human endostatin combined with concurrent chemoradiotherapy could increase effective rate [OR=2.62,95%CI(1.41,4.86),P=0.002].But there were no significant differences in clinical benefit rate [OR=2.08,95%CI(0.92,4.73),P=0.08],one year survival rate [OR=1.18,95%CI(0.53,2.66),P=0.68],improvement in quality of life [OR=1.57,95%CI(0.40,6.07),P=0.52],rate of leucopenia [OR=1.25,95%CI(0.72,2.17),P=0.43],radioactive esophagitis [OR=1.16,95%CI(0.42,3.21),P=0.77] and radiation pneumonitis [OR=2.47,95%CI(0.34,17.68),P=0.37].ConclusionCompared with concurrent chemoradiotherapy alone,recombinant human endostatin combined with concurrent chemoradiotherapy may be more effective for advanced NSCLC,whereas improvement of life quality and toxicities are similar.For the quality restriction and possible publication bias of the included studies,more high quality randomized controlled trials are required to further verify this conclusion.
KEY WORDS Recombinant human endostatin; Lung neoplasms; Concurrent chemoradiotherapy; Metaanalysis