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目的:比较培美曲塞单药与多西紫杉醇单药二线治疗晚期非小细胞肺癌的临床疗效和安全性。方法:采用Cochrane系统评价方法进行资料提取、分析、评价,并使用RevMan 5.0软件进行Meta分析。结果:共纳入5个研究,916例晚期非小细胞肺癌(NSCLC)患者。Meta分析结果显示,与对照组多西紫杉醇相比,培美曲塞治疗晚期NSCLC的总反应率、一年生存率、疾病控制率等的差别无统计学意义,可以认为二者疗效相当。不良反应方面,培美曲塞和多西紫杉醇在轻度及重度中性粒细胞减少、重度血小板下降和轻度脱发方面的发生率方面的差异具有统计学意义。其中,在轻度及重度中性粒细胞减少和轻度脱发方面培美曲塞优于多西紫杉醇,而在重度血小板下降方面多西紫杉醇优于培美曲塞。在其他各个方面的不良反应发生率中,两组差异没有统计学意义。结论:培美曲塞单药二线治疗晚期NSCLC的疗效确切。与多西紫杉醇比较,二者疗效差异不明显,不良反应发生率存在一些差异。
Objective: To compare the clinical efficacy and safety of pemetrexed monotherapy with docetaxel in the second-line treatment of advanced non-small cell lung cancer. Methods: Data were extracted, analyzed and evaluated using the Cochrane systematic review method. Meta-analysis was performed using RevMan 5.0 software. Results: A total of 5 studies were enrolled in 916 patients with advanced non-small cell lung cancer (NSCLC). Meta-analysis showed that compared with the control group docetaxel pemetrexed treatment of advanced NSCLC the overall response rate, one-year survival rate, disease control rate was no significant difference between the two can be considered equivalent efficacy. Adverse reactions, pemetrexed and docetaxel in mild and severe neutropenia, severe thrombocytopenia and mild hair loss in the incidence of differences were statistically significant. Of these, pemetrexed is superior to docetaxel in mild and severe neutropenia and mild alopecia, and docetaxel is superior to pemetrexed in severe thrombocytopenia. In all other aspects of the incidence of adverse reactions, the difference between the two groups was not statistically significant. Conclusions: Pemetrexed monotherapy second-line treatment of advanced NSCLC curative effect is exact. Compared with docetaxel, the difference between the two effects is not obvious, there are some differences in the incidence of adverse reactions.