目的：系统评价依托泊苷联合洛铂（EL）与依托泊苷联合顺铂（EP）治疗广泛期小细胞肺癌的有效性和安全性。方法：计算机检索 Web of Knowledge、PubMed、The Cochrane Library、CBM、CNKI、VIP 及 WanFang Data 关于 EL 方案与 EP 方案治疗广泛期小细胞肺癌的随机对照研究（RCT）。依据 Cochrane Handbook 5．0．1的质量评价标准进行 RCT 筛选、资料提取和质量评价后，采用 RevMan 5．2软件进行 Meta 分析。结果：共纳入4篇 RCT 研究，共计401例患者，Meta 分析结果显示：在疗效方面，EL 方案与 EP 方案相比，两者有效率差异无统计学意义[ORR ＝1．08，95％CI（0．53～2．21），P ＝0．82]。在安全性方面，EL 方案与 EP 方案相比，Ⅲ－Ⅳ度消化道反应发生率差异具有统计学意义[OR ＝0．34，95％CI（0．20～0．58），P ＜0．0001]。而在Ⅲ－Ⅳ度白细胞减少[OR ＝0．77，95％CI（0．37～1．63），P ＝0．50]，Ⅲ－Ⅳ度血小板减少[OR ＝2．81，95％CI（0．74～10．68），P ＝0．13]，Ⅲ－Ⅳ度贫血[OR ＝0．47，95％CI（0．08～2．67），P ＝0．40]等方面差异无统计学意义。结论：EL 方案在疗效方面与 EP 方案大致相当，EL 方案消化道反应轻，患者耐受性好。%Objective:To evaluate therapeutic efficacy and safety of etoposide plus lobaplatin versus etoposide plus cisplatin chemotherapy for extensive stage small cell lung cancer.Methods:We searched Web of Knowledge, PubMed,The Cochrane Library,CNKI,CBM,VIP and WanFang data base for randomized controlled trials comparing EL with EP regimens.Literatures were screened according to Cochrane Handbook 5.0.1 quality evaluation criteria. Meta -analysis was conducted with RevMan 5.2 software.Results:Four RCTs were included,involving 401 patients. The results of Meta -analyses showed that,in the aspect of efficacy,there was no significant difference between the two groups in the effective rate [ORR =1.08,95%CI(0.53 ~2.21),P =0.82].In the aspect of safety,there was significant difference between EL regimen and EP regimen in grade Ⅲ -Ⅳ nausea /vomiting [OR =0.34,95%CI (0.20 ~0.58),P <0.000 1].There were no significant difference between the two groups in the grade Ⅲ -Ⅳ neu-tropenia [OR =0.77,95%CI(0.37 ~1.63),P =0.50],grade Ⅲ -Ⅳ thrombocytopenia[OR =2.81,95%CI(0.74~10.68),P =0.13],grade Ⅲ -Ⅳ anemia [OR =0.47,95%CI(0.08 ~2.67),P =0.40].Conclusion:EL has similar efficacy to EP for extensive stage small cell lung cancer patients,but it has fewer side effects of nausea/vomi-ting.It is well tolerant.
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