·· 中国肺癌杂志2011 年1 月第14 卷第1 期 Chin J Lung Cancer, January 2011, Vol.14, No.1 ·临床研究· 培美曲塞联合铂类对比吉西他滨联合铂类治疗晚期非小细胞肺癌的meta分析姜金李伦王晓晶田金徽王权林乔【摘要】背景与目的培美曲塞联合铂类方案（PP方案）作为晚期非小细胞肺癌（non-small cell lung cancer, NSCLC）一线化疗方案的疗效是否优于吉西他滨联合铂类方案（GP方案），目前尚无定论。本研究旨在评价采用 PP方案与GP方案治疗晚期NSCLC的疗效及安全性。方法计算机检索Pubmed、EMBASE、Cochrane Library、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库等，同时追查纳入文献的参考文献，纳入PP 方案对比GP方案治疗晚期NSCLC的随机对照试验（randomized controlled trial, RCT）。根据Cochrane Handbook 5.0的质量评价标准，用RevMan 5.0软件进行统计学分析。结果共纳入4项RCT，2,235例患者，meta分析结果显示采用PP 方案与GP方案治疗后在1年生存率（OR=1.09, 95%CI: 0.91-1.29）、有效率（OR=1.00, 95%CI: 0.40-2.52）等方面的差异无统计学意义，而在总生存时间（MD=0.26, 95%CI: 0.21-0.30）、脱发（OR=0.51, 95%CI: 0.39-0.66）及血液毒性等方面的差异有统计学意义。结论 PP方案与GP方案在1年生存率、有效率方面疗效相当，在总生存时间、不良反应等方面有差异，PP方案可能对不耐受血液毒性、脱发等患者更适合。【关键词】培美曲塞；吉西他滨；铂类；肺肿瘤【中图分类号】 R734.2 A meta-analysis of Pemetrexed plus Platinum Chemotherapy versus Gemcitabine plus Platinum Chemotherapy for Advanced Non-small Cell Lung Cancer Jin JIANG 1,2 , Lun LI 1,3 , Xiaojing WANG 1,2 , Jinhui TIAN 1 , Quan WANG 1,3 , Qiao LIN 1,2 1 Evidence Based Medicine Center of Lanzhou University, School of Basic Medical Science of Lanzhou University, Lanzhou 730000, China; 2 e First Clinical Medical College of Lanzhou University, Lanzhou 730000, China; 3 e Second Clinical Medical College of Lanzhou University, Lanzhou 730000, China Corresponding author: Jinhui TIAN, E-mail: tjh996@163.com 【Abstract】 Background and objective Whether pemetrexed plus platinum (PP) regimen is superior to gem- citabine plus platinum (GP) regimen for patients with advanced non-small cell lung cancer (NSCLC) is unclear. e aim of this study is to evaluate the eﬃcacy and safety of PP versus GP regimens for patients with NSCLC. Methods We searched relevant randomized controlled trials (RCTs) from Pubmed, EMBASE, Cochrane Library, Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Chinese Scientiﬁc Journals Full-text Database, and traced the related references to obtain the information that has not been found. We made quality assessment of qualiﬁed RCTs assessed by the exclusion and inclusion criteria and used RevMan 5.0 provided by the Cochrane Collaboration to perform meta-analysis. Results Four RCTs involving 2,235 patients were identiﬁed. ere were no statistical diﬀerences between PP and GP regimens in one-year survival rate (OR=1.09, 95%CI: 0.91-1.29), the eﬃciency of disease (OR=1.00, 95%CI: 0.40-2.52), but overall survival (MD=0.26, 95%CI: 0.21-0.30), alopecia (OR=0.51, 95%CI: 0.39-0.66) and hematologic toxicity were signiﬁcantly diﬀerent. Conclusion e clinical eﬃciency of PP and GP regimens for advanced NSCLC was similar, but the side eﬀects were diﬀerent. e toxicity of PP regimen has the tendency to be more tolerable. 【Key words】 Pemetrexed; Gemcitabine; Platinum; Lung neoplasms This study was supported by grants from the Teaching and Research Project of Lanzhou University (No.201022) and Teaching and Innovation Fund of Evidence-Based Medicine Center of Lanzhou University (to Jin JIANG)(No.2010LDEBM-B). DOI: 10.3779/j.issn.1009-3419.2011.01.09 本研究受兰州大学2010教学研究项目（No.201022）、兰州大学循证医学中心循证医学创新项目（No.2010LDEBM-B）资助作者单位：730000 兰州，兰州大学循证医学中心，兰州大学基础医学院（姜金，李伦，王晓晶，田金徽，王权，林乔）；730000 兰州，兰州大学第一临床医学院（李伦，王权）；730000 兰州，兰州大学第二临床医学院（姜金，王晓晶，林乔）（通讯作者：田金徽，E-mail: tjh996@163.com） www.lungca.org