广泛期小细胞肺癌中顺铂联合伊立替康与顺铂联合依托泊苷的Meta分析

目的 评价顺铂联合伊立替康与顺铂联合依托泊苷治疗广泛期小细胞肺癌的临床疗效及安全性。方法：计算机检索Pubmed、Medline、中国知网(CNKI)、维普网(VIP)及万方数据知识服务平台等数据库,筛选关于顺铂联合伊立替康(IP)与顺铂联合依托泊苷(EP)治疗广泛期小细胞肺癌的相关文献,检索时间为建库至2018年8月。实验组患者采用顺铂联合伊立替康,对照组患者采用顺铂联合依托泊苷；采用RevMan 5.3.0软件进行Meta分析。结果 最终纳入8篇文献,均为中文文献,包括488例患者,IP组与EP组临床有效率(RR)(OR=1.06,95%CI：0.93～1.21,P=0.41)、疾病控制率(DCR)(OR=1.02,95%CI：0.91～1.13,P=0.77)方面上差异无统计学意义。在安全性方面,IP主要表现为消化道毒性(OR=3.8,95%CI：2.39～6.02,P＜0.00001),EP主要表现为血液毒性,特别是中性粒细胞减少(OR=0.45,95%CI：0.29～0.70,P=0.0004)。结论 IP方案的疗效与EP方案相似，对小细胞癌有较好的临床应用价值。IP方案毒性主要表现在消化系统，EP方案毒性主要表现在骨髓抑制。

A meta analysis of Cisplatin combined with irinotecan and cisplatin combined etoposide in the first-line treatment for extensive stage small cell lung cancer

Objective To assess the efficacy and safety of etoposide combined with irinotecan and cisplatin regimens in patients with extensive small cell lung cancer.Methods we searched Pubmed,Medline,CNKI,VIP and WanFang Data to collect the literature on cisplatin combined with irinotecan (IP) and cisplatin combined with etoposide (EP) in the treatment of extensive small cell lung cancer from creating database to August 2018. The experimental group was treated with cisplatin combined with irinotecan, the control group with cisplatin combined with etoposide, and the RevMan 5.3.0 software was used for meta-analysis.Results There was no significant difference in clinical efficacy (RR) (OR = 1.06, 95% CI: 0.93-1.21, P = 0.41), disease control rate (DCR) (OR = 1.02, 95% CI: 0.91-1.13, P = 0.77) between IP group and EP group. In terms of safety, IP was mainly gastrointestinal toxicity (OR = 3.8, 95% CI: 2.39-6.02, P < 0.00001), EP was mainly hematotoxicity, especially neutropenia (OR = 0.45, 95% CI: 0.29-0.70, P = 0.0004). Conclusion The efficacy of IP is similar to EP, and it has better clinical application value for small cell carcinoma. IP toxicity was mainly manifested in the digestive system, EP toxicity was mainly manifested in bone marrow suppression.