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首页> 外文期刊>Medicine. >Meta-analysis of clinical trials comparing the efficacy and safety of liposomal cisplatin versus conventional nonliposomal cisplatin in nonsmall cell lung cancer (NSCLC) and squamous cell carcinoma of the head and neck (SCCHN)
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Meta-analysis of clinical trials comparing the efficacy and safety of liposomal cisplatin versus conventional nonliposomal cisplatin in nonsmall cell lung cancer (NSCLC) and squamous cell carcinoma of the head and neck (SCCHN)

机译：荟萃分析比较了脂质体顺铂与常规非脂质体顺铂在非小细胞肺癌（NSCLC）和头颈部鳞状细胞癌（SCCHN）中的疗效和安全性

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Background: While liposomal cisplatin has shown enhanced drug tolerability and higher targeting property as compared with the conventional cisplatin , the doubt remains whether lipoplatin could improve its anticancer efficacy . What's more, there is still no systematic evaluation of the safety profiles of lipoplatin comparing with original cisplatin . Thus, we performed a systematic literature search for randomized clinical trials directly comparing efficacy and safety of liposomal cisplatin versus its conventional nonliposomal cisplatin . Methods: The electronic search was conducted in PubMed, Embase, The Cochrane Library, and ClinicalTrials.gov from inception to February 10, 2018. The pooled odds ratio (OR) and 95% confidence intervals (CIs) of progressive disease (PD), partial response (PR), stable disease (SD), and adverse events (AEs) were obtained to assess the efficacy and safety . Heterogeneity was estimated using the I sup xmlns:mrws="2 test ( I sup xmlns:mrws="2 50%, significant heterogeneity). Results: The search yielded 5 clinical trials that meet inclusion criteria, with a total of 523 patients. We found that the liposome encapsulated cisplatin was more clinical efficacious than cisplatin as assessed by PD rate (OR, 0.46; 95% CI, 0.28–0.74; P = .002), while subgroup analysis of the only nonsmall cell lung cancer (NSCLC) patients showed higher response rates in PR (OR, 0.46; 95% CI, 0.28–0.74; P = .002) and PD (OR, 0.46; 95% CI, 0.28–0.74; P = .002) simultaneously. In addition, the toxicity meta-analysis revealed lipoplatin was much less toxic than the original cisplatin , with respect to grade 3 to 4 neurotoxicity (OR, 0.18; 95% CI, 0.04–0.74; P = .02), grade 3 to 4 leukopenia (OR, 0.47; 95% CI, 0.26–0.85; P = .01), grade 3 to 4 neutropenia (OR, 0.26; 95% CI, 0.09–0.71; P = .009), grade 1 and 2 nausea/vomiting (OR, 0.50; 95% CI, 0.32–0.77; P = .002), and grade 3 and 4 asthenia (OR, 0.11; 95% CI, 0.03–0.42; P = .001). Conclusions: This meta-analysis revealed that with both NSCLC and squamous cell carcinoma of the head and neck (SCCHN) patients, liposomal cisplatin -based chemotherapy offers significant advantages regarding the PD and reduced toxicities relative to conventional cisplatin .
机译：背景：尽管与常规顺铂相比，脂质体顺铂已显示出更高的药物耐受性和更高的靶向性，但人们仍然怀疑脂质铂是否可以提高其抗癌功效。而且，与原始的顺铂相比，仍然没有系统评价脂铂的安全性。因此，我们进行了系统的文献搜索，以直接比较脂质体顺铂与常规非脂质体顺铂的疗效和安全性进行随机临床试验。方法：从开始到2018年2月10日，在PubMed，Embase，Cochrane图书馆和ClinicalTrials.gov中进行电子搜索。进行性疾病（PD）的合并比值比（OR）和95％置信区间（CIs），获得部分反应（PR），稳定疾病（SD）和不良事件（AEs）来评估疗效和安全性。异质性是使用I 50％，显着异质性）进行估计的。结果：搜索获得5项符合纳入标准的临床试验，共523例患者。我们发现通过PD率评估，脂质体包裹的顺铂比顺铂更具临床疗效（OR为0.46; 95％CI为0.28–0.74; P = 0.002），而只有非小细胞肺癌（NSCLC）的亚组分析患者的PR（OR，0.46; 95％CI，0.28–0.74; P = .002）和PD（OR，0.46; 95％CI，0.28–0.74; P = .002）同时显示较高的缓解率。此外，毒性荟萃分析显示，相对于3至4级神经毒性（OR，0.18; 95％CI，0.04–0.74; P = .02），对于3至4级，脂铂的毒性比原始的顺铂低得多。白细胞减少症（OR，0.47; 95％CI，0.26-0.85; P = .01），3至4级中性粒细胞减少症（OR，0.26; 95％CI，0.09–0.71; P = .009），1级和2级恶心/呕吐（OR，0.50; 95％CI，0.32-0.77; P = 0.002），以及3级和4级虚弱（OR，0.11; 95％CI，0.03-0.42; P = .001）。结论：这项荟萃分析显示，对于NSCLC和头颈部鳞状细胞癌（SCCHN）的患者，基于顺铂脂质体的化疗相对于常规顺铂而言，在PD方面具有显着的优势，并降低了毒性。

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