阿帕替尼治疗晚期非小细胞肺癌疗效与安全性的Meta分析

Meta-analysis of the efficacy and safety of apatinib in the treatment of advanced non-small cell lung cancer

摘要:

目的 系统评价阿帕替尼对比紫杉醇/多西他赛治疗晚期非小细胞肺癌（NSCLC）的疗效与安全性，为临床用药提供参考。方法 计算机检索从建库至2019年8月中国知网、维普网、万方数据库、PubMed及Cochrane Library数据库，对符合纳入标准的随机对照试验进行质量评价，用RevMan 5.3软件进行Meta分析。结果 共纳入9篇文献，均为随机对照试验，合计637例患者。Meta分析结果显示：阿帕替尼组客观缓解率高于紫杉醇/多西他赛组［O=1.77（95% CI：1.15，2.72）］，疾病控制率高于紫杉醇/多西他赛组［O=2.15（95% CI：1.42，3.24）］，KPS评分高于紫杉醇组［均数差=6.84（95% CI：4.84，8.84）］，骨髓抑制发生情况低于紫杉醇/多西他赛组［R=0.39（95% CI：0.26，0.57）］，胃肠道不良反应发生情况低于紫杉醇/多西他赛组［R=0.50（95% CI：0.33，0.76）］。结论 阿帕替尼对比紫杉醇/多西他赛治疗晚期NSCLC能提高客观缓解率及疾病控制率，健康状况和生活质量更佳，骨髓抑制及胃肠道不良反应发生率较低。

Abstract:

Objective To systematically evaluate the efficacy and safety of apatinib compared with paclitaxel or docetaxel monotherapy for advanced non-small cell lung cancer and therefore to provide references for clinical medication.Methods Articles about apatinib versus paclitaxel or docetaxel monotherapy for advanced non-small cell lung cancer were searched in CNKI, CQVIP, Wanfang Data, PubMed and Cochrane Library. The quality of the randomized controlled trials (RCTs) meeting inclusion criteria was evaluated, and the meta-analysis was performed by RevMan5.3 software.Results A total of 9 RCTs were included, involving 637 patients. The meta-analysis showed that compared with paclitaxel or docetaxel monotherapy for advanced non-small cell lung cancer, apatinib improved the objective response rate [R = 1.77 (95% CI: 1.15, 2.72)] and disease control rate [R = 2.15 (95% CI: 1.42, 3.24)]. The health status of patients receiving apatinib was better than that of those receiving paclitaxel as assessed by Karnofsky Performance Scale [MD=6.84 (95% CI: 4.84, 8.84)]. Besides, the incidences of myelosuppression [R = 0.39 (95% CI: 0.26, 0.57)] and gastrointestinal adverse reactions [R=0.50 (95% CI: 0.33, 0.76)] in patients with apatinib therapy were lower than those in patients with paclitaxel or docetaxel monotherapy.Conclusions In comparison to paclitaxel or docetaxel, apatinib can improve objective response rate and disease control rate, enhance the health status and the quality of life of patients, and lower the incidences of myelosuppression and gastrointestinal adverse reactions in the treatment of advanced non-small cell lung cancer.