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已发表论文
多西紫杉醇 (Docetaxel) 在晚期非小细胞肺癌 (NSCLC) 治疗中的功效和安全性： 对第三节随机对照试验的一项综合分析
Authors He X, Wang J, Li Y
Received 28 March 2015
Accepted for publication 27 May 2015
Published 4 August 2015 Volume 2015:8 Pages 2023—2031
DOI http://dx.doi.org/10.2147/OTT.S85648
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 4
Editor who approved publication: Dr Faris Farassati
Background: Several clinical trials have performed risk–benefit analyses comparing docetaxel and pemetrexed or docetaxel and vinca alkaloid, but the efficacy and safety remain uncertain. The aim was to conduct a meta-analysis to compare the efficacy and safety of docetaxel and pemetrexed or docetaxel and vinca alkaloid for non-small-cell lung cancer.
Methods: This meta-analysis of Phase III randomized controlled trials was performed after searching PubMed, Embase, the Cochrane Library, and the ISI Web of Knowledge for randomized controlled trials. Outcome analyses were overall survival, progression-free survival, and overall response rate with 95% confidence intervals and major grade 3/4 toxicity.
Results: Seven eligible trials involving 2,080 patients were retrieved for analysis. Docetaxel enhanced progression-free survival and overall response rate compared with vinca alkaloid as first-line treatment (P <0.05). However, there was no difference between docetaxel and pemetrexed as both first-line and second-line treatment (P >0.05). With regard to the grade 3/4 toxicity, compared with pemetrexed, docetaxel led to higher neutropenia and febrile neutropenia (P <0.05), but there was no difference in non-hematological toxicity (P >0.05). Docetaxel led to a lower rate of anemia as first-line treatment (P <0.05). Moreover, docetaxel caused less grade 3/4 hematological and non-hematological toxicity compared with vinca alkaloid.
Conclusion: Docetaxel leads to a better result than vinca alkaloid in effectiveness and safety on patients with advanced non-small-cell lung cancer as first-line therapy. Docetaxel also causes lower toxicity as second-line therapy compared with vinca alkaloid. However, the differences in efficacy and safety between docetaxel and pemetrexed are not obvious. Further clinical study with more details, such as sex, age, histology, and so on, should be considered for illustrating the differences between these two drugs.
Keywords: docetaxel, NSCLC, risk-benefit analysis, systematic review
Methods: This meta-analysis of Phase III randomized controlled trials was performed after searching PubMed, Embase, the Cochrane Library, and the ISI Web of Knowledge for randomized controlled trials. Outcome analyses were overall survival, progression-free survival, and overall response rate with 95% confidence intervals and major grade 3/4 toxicity.
Results: Seven eligible trials involving 2,080 patients were retrieved for analysis. Docetaxel enhanced progression-free survival and overall response rate compared with vinca alkaloid as first-line treatment (P <0.05). However, there was no difference between docetaxel and pemetrexed as both first-line and second-line treatment (P >0.05). With regard to the grade 3/4 toxicity, compared with pemetrexed, docetaxel led to higher neutropenia and febrile neutropenia (P <0.05), but there was no difference in non-hematological toxicity (P >0.05). Docetaxel led to a lower rate of anemia as first-line treatment (P <0.05). Moreover, docetaxel caused less grade 3/4 hematological and non-hematological toxicity compared with vinca alkaloid.
Conclusion: Docetaxel leads to a better result than vinca alkaloid in effectiveness and safety on patients with advanced non-small-cell lung cancer as first-line therapy. Docetaxel also causes lower toxicity as second-line therapy compared with vinca alkaloid. However, the differences in efficacy and safety between docetaxel and pemetrexed are not obvious. Further clinical study with more details, such as sex, age, histology, and so on, should be considered for illustrating the differences between these two drugs.
Keywords: docetaxel, NSCLC, risk-benefit analysis, systematic review
