Objective To assess clinical efficacy and safety of Oxaliplatin plus Vinorelbine in the treatment of advanced non-small cell lung cancer (NSCLC).
Methods We used the methods of Cochrane reviews, electronically searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, 2008), MEDLINE (1966 to April 2008), EMbase (1984 to Dec. 2006), Cancerlit (1996 to Dec. 2005), CBM (1978 to April 2008), CNKI (1994 to April 2008), VIP (1989 to April 2008), and handsearched 15 Chinese medical core journals, to collect randomized controlled trials (RCTs) of Oxaliplatin combined with Vinorelbine in the treatment of advanced NSCLC. RCTs were included according to the inclusion and exclusion criteria, the quality of included trials was evaluated and RevMan 4.2.8 software was used for metaanalyses after the extraction of the data.
Results Seventeen RCTs involving 1 399 patients with advanced NSCLC were included. All of them reported the use of a random method, but with no detailed reports of allocation concealment and whether the blind method was used. The results of meta-analyses showed that NO program (vinorelbine + oxaliplatin) and NP program (vinorelbine + cisplatin) were similar in efficient rate (RR=0.97, 95%CI 0.85 to 1.10) and 1-year survival rate (RR=0.82, 95%CI 0.66 to 1.03). Compared with NP program, NO program induced lower III-IV degree of nausea and vomiting response (RR=0.20, 95%CI 0.14 to 0.28), III-IV degree of leukopenia reaction (RR=0.64, 95%CI 0.52 to 0.79), and I-II degree of renal damage RR=0.27, 95%CI 0.11 to 0.60) after chemotherapy. No study reported treatmentrelated death.
Conclusion Oxaliplatin and Cisplatin plus Vinorelbine are similar in efficacy in the treatment of advanced NSCLC. Oxaliplatin plus Vinorelbine could be used as a chemotherapy of advanced NSCLC because of its better tolerance and more liability to be accepted by patients. However, highly-potential selection bias and measurement bias would affect the demonstration level of the outcome, so more high-quality double-blind RCTs are needed.
Citation: DENG Ying,HU Honglin,PAN Haixia,REN Gang,YANG Lan,ZHU Xueqiang,LIU Hao. Oxaliplatin plus Vinorelbine in the Treatment of Advanced Non-small Cell Lung Cancer: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2010, 10(5): 609-617. doi: 10.7507/1672-2531.20100457 Copy