奥沙利铂与卡铂治疗中晚期非小细胞肺癌的meta分析
Meta？？analysis of oxaliplatin versus carboplatin based chemotherapy in treatment of advanced NSCLC

目的：系统评价奥沙利铂联合化疗与卡铂联合化疗治疗中晚期非小细胞肺癌(NSCLC)的有效性和安全性。方法：检索Medline、Cochrane Library、PubMed、EMbase、CNKI、CBM、VIP和WANFANG数据库，收集关于奥沙利铂联合化疗与卡铂联合化疗治疗中晚期NSCLC的随机对照试验(RCT)，采用RevMan 5.1进行meta分析。结果：最终纳入6个RCT，共784例患者。Meta分析显示，两个方案的客观缓解率(OR=0.82,95%CI:0.60~1.14)、客观控制率(OR=0.97,95%CI:0.72~1.31)、Ⅲ？并舳榷裥摹⑴煌路⑸？率(OR=1.02,95%CI: 0.55~1.91)差异无统计学意义，而奥沙利铂联合方案Ⅲ？并舳绕堆？(OR=0.18,95%CI:0.05~0.63)、Ⅲ？并舳劝紫赴？减少(OR=0.29,95%CI:0.15~0.57)、Ⅲ？并舳戎行粤Ｏ赴？减少(OR=0.41,95%CI:0.28~0.61)、Ⅲ？并舳妊？小板减少(OR=0.20,95%CI:0.05~0.71)的发生率较卡铂联合方案明显降低，神经毒性的发生率明显升高(OR=30.58,95%CI:7.17~130.38)。结论：奥沙利铂联合化疗方案治疗中晚期NSCLC疗效与卡铂联合化疗方案相似，但安全性更好。
Aim: To determine the efficacy and toxicity of oxaliplatin based chemotherapy versus carboplatin based chemotherapy for advanced non？？small cell lung cancer（NSCLC）. Methods: The randomized controlled trials(RCTs) on oxaliplatin based chemotherapy versus carboplatin based chemotherapy for advanced NSCLC were searched in Medline, the Cochrane Library, PubMed, EMbase, CNKI, CBM, VIP and WANFANG Data base. A meta？？analysis was carried out by RevMan 5.1.Results: Six trials that included a total of 784 patients were analyzed. The meta？？analysis demonstrated that, compared with the carboplatin based chemotherapy, oxaliplatin based chemotherapy could decrease the risks of hematological toxicity, including grade 3-4 anemia(OR=0.18, 95%CI:0.05-0.63), grade 3-4 leukopenia(OR=0.29, 95%CI:0.15-0.57), grade 3-4 neutropenia (OR=0.41, 95%CI:0.28-0.61), and grade 3-4 thrombocytopenia(OR=0.20, 95%CI:0.05-0.71), but increase the risk of neurotoxicity(OR=30.58, 95%CI:7.17-130.38). There were no significant differences between the two groups in overall response rate(OR=0.82, 95%CI:0.60-1.14), disease control rate(OR=0.97, 95%CI:0.72-1.31), or grade 3？？4 nausea and vomiting(OR=1.02, 95%CI:0.55-1.91). Conclusion: Oxaliplatin based chemotherapy has similar efficacy to carboplatin based chemotherapy, but milder toxicity