培美曲塞维持治疗晚期非小细胞肺癌临床疗效的Meta分析

目的 本研究对培美曲塞维持治疗晚期非小细胞肺癌的临床疗效进行Meta分析。方法 计算机检索Cochrane、Pubmed、Web of science、Embase、临床试验等数据库,同时追溯参考文献。收集培美曲塞维持治疗和最佳支持治疗(Best supportive care,BSC)对非小细胞肺癌相关指标进行随机对照试验(Randomized controlled trial,RCT),根据Cochrane系统评价手册5.3质量评价标准评价,采用Stata 12.0软件和Revman5.3进行Meta分析及GRADEpro软件进行证据的评级。结果 共纳入3篇随机对照试验,共1257名研究对象,Meta分析结果显示,与BSC相比培美曲塞可以延长无进展生存期(Pogression free survival,PFS)(HR=0.55,95%CI:0.48~0.64),以及总生存期(Overall survival,OS)(HR=0.76,95%CI:0.65~0.88),但客观缓解率(Objective response rate,ORR)无统计学意义(RR=0.97,95%CI:0.86~1.10)。结论 与BSC相比,培美曲塞组可明显延长非小细胞肺癌的无进展生存期、总生存期,但在客观缓解率上影响并不显著。

Maintenance therapy with pemetrexed foradvanced non-small cell lung cancer:A Meta-analysis of RCTs

Objective This paper aims to assess the clinical efficacy of pemetrexed maintenance therapy in patients with advanced non-small cell lung cancer( NSCLC) through Meta analysis.Me thods Systematic lit-erature searches were performed in Cochrane、Pubmed,Web of science, Embase and ClinicalTrials databases.The related references had been traced.We made quality assessment of qualified randomized controlled trials( RCTs) of pemetrexed maintenance therapy compared with best supportive care( BSC) in advanced NSCLC.Besides,we u-tilized stata 12.0,Revman 5.3 and GRADEpro software to evaluate the overall quality of the evidence,according to the Cochrane collaboration to perform Meta-analysis.Resutl s Three RCTs were eligible and included 1257 patients.Meta-analysis results suggested that:compared to BSC,pemetrexed maintenance therapy had a statisti-cally significant benefit in improving progression-free survival(PFS)(HR =0.55,95% CI:0.48~0.64)and overall survival(HR=0.76,95%CI:0.65~0.88).The objective response(ORR)did not reach statistical signif-icance(RR=0.97,95%CI:0.86~1.10).Conclusion Compared with BSC,pemetrexed maintenance therapy statistically significantly improve PFS and OS,but has no demonstrable impact on ORR in patients with advanced NSCLC.