本文選題：吉非替尼　切入點(diǎn)：厄洛替尼　出處：《重慶醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:采用系統(tǒng)評價的方法,對表皮生長因子受體酪氨酸激酶抑制劑(吉非替尼或者厄洛替尼)和多西他賽用于晚期非小細(xì)胞肺癌患者二線治療的治療效果以及其安全性進(jìn)行對比。方法:檢索PUBMED、Cochrane Library、Embase、CNKI、萬方、維普等數(shù)據(jù)庫,收集1995年1月至2015年3月間,與表皮生長因子受體酪氨酸激酶抑制劑對比多西他賽二線治療晚期非小細(xì)胞肺癌有關(guān)的臨床隨機(jī)對照試驗(RTC),2名獨(dú)立研究員根據(jù)納入與排除標(biāo)準(zhǔn)篩選文獻(xiàn),進(jìn)行文獻(xiàn)質(zhì)量評價,計算風(fēng)險比(HR)值、相對危險度(RR)值以及他們各自的95%可信區(qū)間(CI),所有數(shù)據(jù)均采用Review Manager 5.3.0軟件進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:6篇符合條件的臨床隨機(jī)對照試驗(RTC)被此次meta分析所采用,總計納入2747例一線治療失敗的非小細(xì)胞肺癌患者,其中1389例患者接受EGFR-TKI治療,1358例患者接受多西他賽治療。Meta分析結(jié)果顯示EGFR-TKI與多西他賽相比,兩組患者總生存期的差異(HR=1.05,95%CI=0.96~1.14,Z=0.97,P=0.33)無顯著統(tǒng)計學(xué)意義。多西他賽治療組患者的無進(jìn)展生存期較厄洛替尼治療組有所改善(HR=1.31,95%CI=1.11~1.54,Z=3.24,P=0.001),但在多西他賽與厄洛替尼治療組中無明顯差異(HR=0.90,95%CI=0.78~1.04,Z=1.40,p=0.16)。在安全性分析方面,EGFR-TKI組3~4級不良反應(yīng)的發(fā)生率較低,如中性粒細(xì)胞減少癥(RR=0.06,95%CI=0.04~0.08)、發(fā)熱性中性粒細(xì)胞減少(RR=0.09,95%CI=0.05~0.16)、神經(jīng)毒性(RR=0.25,95%CI=0.05~0.16)等,但3~4級皮疹(RR=15.03,95%CI=5.81~38.88)的發(fā)生率有所增加。結(jié)論:在非小細(xì)胞肺癌的二線治療中,EGFR-TKI與多西他賽治療組患者的總生存期及無進(jìn)展生存期無顯著差異,但EGFR-TKI可能更安全,患者耐受性更好,可以為非小細(xì)胞肺癌患者的二線治療提供更多選擇。
[Abstract]:Objective: to adopt the method of systematic evaluation, To compare the efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitor (gefitinib or erlotinib) and docetaxel in the treatment of patients with advanced non-small cell lung cancer. Databases such as Wiper, which collected data from January 1995 to March 2015, A randomized controlled trial (RTCU) associated with epidermal growth factor receptor tyrosine kinase inhibitor (EGF receptor tyrosine kinase inhibitor) for the treatment of advanced non-small cell lung cancer (NSCLC) compared with docetaxel two independent researchers sifted the literature according to the inclusion and exclusion criteria to evaluate the quality of the literature. The risk ratio (RHR), relative risk (RR) and their 95% confidence intervals were calculated. All the data were statistically analyzed using Review Manager 5.3.0.Results the meta analysis was performed on 6 eligible randomized controlled trials. A total of 2,747 patients with non-small cell lung cancer (NSCLC) who failed first-line treatment were included, of whom 1389 received EGFR-TKI therapy and 1358 received docetaxel. Meta-analysis showed that EGFR-TKI was compared with docetaxel. There was no significant difference in the total survival time between the two groups. There was no significant difference between the two groups. There was no significant difference between the docetaxel group and the erlotinib group, but there was no significant difference between the docetaxel treatment group and the erlotinib treatment group in the progression free survival time of the two groups, but there was no significant difference between the docetaxel treatment group and the erlotinib treatment group in the progressive survival time of the two groups compared with that in the erlotinib treatment group, but there was no significant difference between the docetaxel treatment group and the erlotinib treatment group. HRR 0.90 ~ 95% CIQ 0.781.40 ~ 0.160.The incidence of adverse reactions in EGFR-TKI group was lower than that in EGFR-TKI group (P < 0.05), and the incidence of adverse reactions was lower in EGFR-TKI group (P < 0.05). For example, the neutropenia is 0.06 ~ 95CII 0.04 ~ 0.08, the fever neutropenia is 0.09 ~ 95 ~ 0.16, the neurotoxicity is 0.25 ~ (95) ~ (0.05) ~ 0.16), and so on. However, the incidence of RRN 15.03C95CI5.81 / 38.88) increased. Conclusion: there is no significant difference in the overall survival and progression-free survival between the EGFR-TKI and docetaxel groups, but EGFR-TKI may be safer and the patient has better tolerance. This can provide more options for second-line therapy in patients with non-small cell lung cancer (NSCLC).
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R734.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 Rafael Rosell;Ramón Palmero;;PD-L1 expression associated with better response to EGFR tyrosine kinase inhibitors[J];Cancer Biology & Medicine;2015年02期

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本文編號：1576219