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.
摘要:目的:观察吉西他滨(GEM)联合长春瑞滨(NVB)对老年晚期非小细胞肺癌(N SCLC)患者的疗效和毒副反应。方法:36例经病理组织学或细胞学确诊的晚期NSCLC患者给予吉西他滨1000 mg/m2,第1、 8 天;长春瑞滨25 mg/m2,加入100 m l生理盐水中静脉冲注,第1、 8 天。每21天为一周期,每月CT扫描,观察疗效,有效者共用四周期后停药,按照WHO疗效评价标准评价疗效,并定期复查随访。结果:36例入选患者中,可评价疗效者31例,完全缓解(CR)0例,部分缓解(PR)7例,稳定(NC)13例,病情进展(PD)11例。有效率(RR)为22.58%(7/31),疾病控制脊髓(CR+PR+NC)为64.52%(20/31),中位肿瘤进展时间为5.8个月,1年生存率42%。最常见的毒副反应为Ⅱ―Ⅲ度抑制。结论:对于失去手术或放疗治疗的老年晚期非小细胞肺癌(N SCLC)患者,吉西他滨(GEM)联合长春瑞滨(NVB)是有效的姑息治疗方案之一,值得临床进一步研究。