| Objective:Lung cancer in today’s fast-paced social life has become one of the more common disease,posing a great threat to human life.Its morbifity and mortality is gradually rising trend.Lung cancer divides into small-cell lung cancer(SCLC) and non-small-cell lung cancer(NSCLC).NSCLC proliferation compared commonly early,found when he has missed the operation opportunity,.the main treatment of patients with advanced NSCLC is medical treatment,including platinum chemotherapy drugs to standard first-line chemotherapy regimens.Currently the main chemotherapy drugs of patients who treated in the first-line chemotherapy failure are docetaxel and pemetrexed.But,the two drugs in terms of efficacy still has great room to imorove,and patients with difficult to tolerate the side effects. Recent development and development of selective molecular targeted drugs than traditional chemotherapy drugs have the potential to improve the effect of non-small cell lung cancer, and reduce the cytotoxicity.Molecular targeted drugs is on the way of antitumor human exploration of a new class of research results, can prolong life,improve the quality of life.Small molecular tyrosine kinase inhibitor(EGFR-TKIs) as EGFR is one of the categories of the present study more molecular targeted drugs.The world has been developed and used in clinical the treatment of drugs such as,gefitinib(Iressa) 、erlotinib(Tarceva)、Icotinib and so on.Application of Meta analysis evaluate the clinical treatment efficacy and safety of gefitinib versus second-line chemotherapy drugs in non-small cell lung cancer(NSCLC), provide a basis for evidence-based medicine in clinical.Methods:Computer retrieval Pub Med, Wanfang Data knowledge、CNKI、Medline, retrieve the fixed number of year from libraries to 2016 January. Included in all relevant gefitinib and second-line chemotherapy randomized controlled trials for the treatment of NSCLC, at the same time all checked out documents of reference as a supplement. By reading title,abstract or the full text literature, According to the inclusion/ exclusion criteria, the use of double parallel excerpt methods were carried out by two researchers, and cross-checking,when disagreements were resolved by discussion or by a third party to decide. For lack of information through the contact author to complement, the data includes the number of patients, characteristics, intervention, outcome indicators and so on. Choose the PR、DCR、 ORR、neutropenia rate、nausea and vomiting rate、diarrhea rate、rash rate in patients with NSCLC as a final analysis indicators. On into the research of RCT quality evaluation and data extraction, then use Rev Man 5.2 software to complete the statistical analysis.Results:According to the selection criteria, eight articles were included in the study, a total of 2419 patients were selected, the gefeitinib group 1220 examples, the second-line chemotherapy group 1199 examples.The baseline characteristics of two groups were similar.The Meta statistical showed as follow: Compared with second-line chemotherapy group, gefitinib group of patients with NSCLC, partial response(OR=0.86, 95%CI=0.64-1.17 、P=0.34),disease control rate(OR=1.06, 95%CI=0.90-1.26 、 P=0.49),objective response rate(OR=1.00,95%CI=0.82-1.23、P=0.97), the difference was not statistically significant.the quality of life period(OR=2.34, 95%CI=1.90-2.88),neutropenia rate(OR=0.03,95%CI=0.02-0.04、P<0.00001),nausea and vomiting rate(OR=0.52,95%CI=0.42-0.63、P < 0.00001),diarrhea rate(OR=1.81, 95%CI=1.51-2.16 、 P < 0.00001),And rash rate(OR=9.05, 95%CI=7.23-11.33 、 P < 0.00001),there was statistically significant difference.Conclusion:In PR,DCR,ORR and so on,gefitinib and second-line chemotherapy drugs have no obvious difference.Gefitinib group has a significantly lower incidence than second-line chemotherapy group in the level 3 to 4 neutropenia rate,nausea and vomiting rate. But second-line chemotherapy group has a significantly lower incidence than gefitinib group in the level 3 to 4 neutropenia rate,nausea and vomiting rate. |
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