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目的比较埃克替尼和其他表皮细胞生长因子受体(EGFR)酪氨酸激酶抑制剂(TKIs)类药物在治疗非小细胞肺癌(NSCLC)的有效性及安全性。方法检索Pub Med、Em Base、Cochrane Library、Web of Science、中国知网、中国生物医学文献数据库、万方数据库及维普中文生物医学期刊数据库,纳入埃克替尼与其他EGFR-TKI治疗非小细胞肺癌患者的随机对照试验(RCT),检索时限为建库至2016年3月。由2位研究者独立对纳入的文献进行筛选、提取资料,然后用Rev Man 5.3软件进行分析。结果共纳入符合标准的RCTs共5项,共涉及633例病例,其中试验组(埃克替尼组)318例,对照组(其他EGFR-TKIs治疗组)315例。Meta分析显示,组间异质性检验结果良好,可用固定效应模型进行分析。试验组与对照组在有效率、疾病控制率方面差异均无统计学意义(均P>0.05)。2组药物不良反应主要以皮疹和腹泻为主,且有肝功能损伤等其他药物不良反应的报道,差异均无统计学意义(均P>0.05)。结论在治疗非小细胞肺癌的有效性及安全性方面,埃克替尼与其他EGFR-TKI(如吉非替尼、厄洛替尼)相当。
Objective To compare the efficacy and safety of imatinib and other epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in the treatment of non-small cell lung cancer (NSCLC). Methods The database of PubMed, Em Base, Cochrane Library, Web of Science, CNKI, China Biomedical Literature Database, Wanfang Database and VIP Chinese Journal of Biomedical Journals was enrolled in this study. Icutinib and other EGFR-TKI were used to treat non-small cell Lung cancer patients randomized controlled trial (RCT), search time limit for the building to March 2016. The two investigators independently screened the incorporated literature, extracted the data, and analyzed it using RevMan 5.3 software. Results A total of 5 RCTs were included in the study. A total of 633 cases were involved, including 318 in the test group (Icitinib group) and 315 in the control group (other EGFR-TKIs-treated group). Meta-analysis showed good inter-group heterogeneity and was analyzed using a fixed-effects model. The experimental group and control group in the efficiency, disease control rate differences were not statistically significant (P> 0.05). Adverse reactions of two groups were mainly rash and diarrhea, and there were no reports of other adverse drug reactions such as liver function impairment (all P> 0.05). Conclusion Icititin is equivalent to other EGFR-TKIs (such as gefitinib and erlotinib) in the treatment of non-small cell lung cancer.