一线用药的EGFR－TKIs与化疗治疗基因突变型NSCLC疗效比较的Meta分析

目的：系统评价表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor tyrosine kinase inhibitors，EGFR－TKIs）与化疗一线治疗基因突变型非小细胞肺癌（non－small cell lung cancer，NSCLC）患者的疗效比较。方法：自PubMed、Cochrane Library、Embase中检索相关的主题词及自由词，收集EGFR－TKIs与化疗相比一线治疗基因突变型NSCLC疗效的随机对照研究（randomized controlled trials，RCT）。按纳入标准及排除标准筛选文献，采用Cochrane偏倚风险评估表对纳入文献进行质量评价，自纳入文献中提取有效数据，应用RevMan 5．3．5和STATA 12．0分析基因突变型晚期NSCLC患者在EGFR－TKIs治疗中的疗效。敏感性分析和发表偏倚分析以评价结果的稳定性和可靠性。结果：共纳入5篇RCT，共1091例患者，对于EG-FR基因变异型晚期NSCLC患者：EGFR－TKIs一线治疗与化疗相比，有较好的无进展生存期（PFS）、客观反应率（ORR），但总体生存期（OS）两者无明显差异。结论：EGFR基因突变的晚期NSCLC患者接受一线EGFR－TKIs治疗相比化疗获益更多。

A Meta-analysis on effectiveness of EGFR-TKIs compared with chemotherapy as first-line treatment of EGFR mutation-selected non-small cell lung cancer

Objective:To analyze the effectiveness of EGFR-TKIs compared with chemotherapy as first-line on the EGFR mutation-selected patients with non-small cell lung cancer(NSCLC).Methods:Randomized controlled trials(RCT)evaluating the effectiveness of EGFR-TKIs compared with chemotherapy as first line treatment of the EGFR mutation-selected NSCLC were obtained from PubMed,the Cochrane Library and Embase.All literatures were assessed by the inclusion and exclusion criteria,quality assessment and data abstraction.The Meta-analysis was per-formed by RevMan 5.3.5(Cochrane Collaboration)and STATA 12.0(STATA Corp,College station,TX)software and was contrasted in EGFR-TKIs-treatment of the EGFR mutation-selected NSCLC patients curative effect.The stability and reliability were evaluated by sensitivity analysis and publication bias analysis.Results:A total of 5 trials with 1 09 1 patients were included in the Meta-analysis.Compared with the chemotherapy group,EGFR-TKI as first-line therapy group in EGFR mutation-selected advanced NSCLC patients showed a higher ORR and PFS,but the OS did not significantly differ.Conclusion:Compared with chemotherapy,EGFR mutation-selected advanced NSCLC patients received more benefits from EGFR-TKIs as first-line treatment.