干扰素维持治疗小细胞肺癌的Meta分析

目的系统评价干扰素(IFN)维持治疗小细胞肺癌(SCLC)的临床疗效。方法采用Cochrane系统评价的方法,电子检索MEDLINE (1966-2006．1)、EMbase(1984-2006．1)、Cochrane图书馆(2006年第1期)、中国生物医学文献数据库(1980-2006．1),手工检索相关会议的Education Book及相关试验的参考文献。评价纳入研究的方法学质量,提取有效数据,采用RevMan 4．2．7软件进行Meta分析。结果共纳入5个随机对照试验,587例患者。Meta分析结果显示,SCLC化疗缓解后应用IFN维持治疗不能改善患者的1年及2年生存率,其RR(95％CI)分别为1．19(0．88,1．61)和1．44(0．99,2．10),而应用IFN-α可以明显改善患者1年及2年生存率,其RR(95％CI)分别为2．08(1．16,3．72)和2．99(1．13, 7．93)。结论SCLC化疗缓解后应用IFN-α维持治疗可以改善患者的1年及2年生存率,但需大样本多中心随机对照试验进一步证实此结果。

Meta-analysis of Maintenance Therapy With Interferon for Small Cell Lung Cancer

Objectives To evaluate the efficacy of interferon (IFN) maintenance therapy in patients with small cell lung cancer (SCLC). Methods We searched MEDL1NE (1966-Jan.2006), EMbase (1984-Jan.2006), The Cochrane Library(Issue 1, 2006)and the Chinese Biomedical Database (1980-Jan.2006). We checked the references in the reports of related studies and handsearched the education books of ASCO and ESMO meetings. The quality of the included trials was evaluated. Data were extracted by two reviewers independently into a specially designed extraction form. The Cochrane Collaboration's RevMan 4.2.7 software was used for data analysis. Results Five randomized controlled trials involving 587 patients were included. The pooled result of the 5 studies showed that IFN plus chemotherapy induction treatment did not have a significant effect on 1-year (RR 1.19, 95%CI 0.88-1.6) or 2-year survival rate (RR 1.44, 95% CI 0.99-2.10). However, IFN maintenance therapy significantly increased 2-year (RR 2.08, 95%CI 1.16-3.72) and 1-year survival (RR 2.99,95%CI 1.13-7.93). Conclusion IFN maintenance therapy may increase 2-year and 1-year survival rates after patients have achieved complete or partial response to chemotherapy. Further randomized, double-blind multi-center trials are needed to investigate this further.