标题：重组人血管内皮抑制素联合NPE方案治疗晚期非小细胞肺癌疗效的Meta分析

      作者：蔡秋燕，王静，曾桂星，罗玉玲，刘升明，陈丽    暨南大学附属第一医院呼吸与危重科，广东 广州 510630

      卷次： 2021年32卷4期

      【摘要】 目的 评价重组人血管内皮抑制素联合长春瑞滨+顺铂方案(NPE)治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性。方法 使用计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、ClinicalTrials、中国知网、万方数据库及维普等数据平台，检索时间为自建库至2020年9月，收集NPE与长春瑞滨＋顺铂方案(NP)方案治疗晚期NSCLC的随机对照试验(RCTs)，由两名研究者独立提取文献信息及评价纳入研究偏倚，采用RevMan5.3.0软件进行Meta分析。结果 共纳入23项前瞻性临床研究，合计1 806例晚期NSCLC患者；Meta分析结果显示，NPE方案治疗晚期NSCLC的客观有效率(RR=1.76，95%CI：1.53~2.02，P<0.000 01)、临床受益率[RR=1.21，95%CI：1.14~1.28，P<0.000 01)以及治疗前后血清癌胚抗原(carcinoembryonic antigen，CEA)水平下降程度(MD=7.65，95%CI：3.17~12.12，P=0.000 8)均高于NP方案；两方案在白细胞下降、血小板下降、胃肠道反应、肝功能损害的不良反应方面比较差异均无统计学意义(P>0.05)，但是，NPE方案的心脏毒性发生风险高于NP方案(RR=2.52，95%CI：1.44~4.43，P=0.001)。结论 与晚期NSCLC患者的NP治疗方案相比，NPE方案能提高治疗的客观有效率和临床受益率，且不良反应可耐受，值得进一步临床应用。
      【关键词】 重组人血管内皮抑制素；长春瑞滨；顺铂；晚期非小细胞肺癌；Meta分析
      【中图分类号】 R734.2 【文献标识码】 A 【文章编号】 1003—6350（2021）04—0526—07

Efficacy of rh-Endostatin combined with NPE chemotherapy in the treatment of advanced non-small cell lungcancer: a meta-analysis.
CAI Qiu-yan, WANG Jing, ZENG Gui-xing, LUO Yu-ling, LIU Sheng-ming, CHEN Li.Department of Respiratory and Critical Care, the First Affiliated Hospital of Jinan University, Guangzhou 510630,Guangdong, CHINA
【Abstract】 Objective To evaluate the efficacy and safety of rh-Endostatin plus the combination of vinorelbineand cisplatin (NPE) in the treatment of advanced non-small cell lung cancer (NSCLC). Methods Data platforms suchas PubMed, EMbase, The Cochrane Library, Web of Science, ClinicalTrials, CNKI, WANFANG DATA and VIP were re-trieved by computer to collect randomized controlled trials (RCTs) on NPE regimen for advanced NSCLC from incep-tion to September 2020. Meta-analysis was performed using RevMan 5.3.0 software after two investigators independent-ly extracted the data and assessed the risk of bias in the included studies. Results A total of 23 trials with 1 806 patientswith advanced NSCLC were included. Meta-analysis results suggested that objective response rate (ORR), clinical bene-fit rate (CBR), and decrease of carcinoembryonic antigen (CEA) after treatment in the NPE group were significantlyhigher than that in the NP group, respectively: ORR, RR=1.76, 95% CI 1.53—2.02, P<0.000 01; CBR, RR=1.21, 95%CI1.14—1.28, P<0.000 01; decrease of CEA, MD=7.65，95%CI: 3.17—12.12，P=0.000 8. There were no significant differ-ence between the two groups in adverse reactions, such as leukopenia, thrombocytopenia, nausea and vomiting, and damagein liver (P>0.05). Risk of cardiotoxicity was higher in the NPE group than in the NP group (RR=2.52, 95%CI 1.44—4.43,P=0.001). Conclusion Compared with NP chemotherapy, NPE chemotherapy can improve the rates of response andthe clinical benefit with tolerable adverse effects, which is worthy of further clinical application.
      【Key words】 Rh-Endostatin; Vinorelbine; Cisplatin; Advanced non-small cell lung cancer; Meta-analysis·荟萃分析·doi:10.3969/j.issn.1003-6350.2021.04.032基金项目：暨南大学科研培育与创新基金跃升计划项目(编号：21617491)