2020 年第 4 期 第 15 卷

安罗替尼治疗晚期非小细胞肺癌效果和安全性的Meta分析

Efficacy and safety of anlotinib in treatment of advanced non-small cell lung cancer: a meta analysis

作者：杨雳何杰任召强李小燕徐可

英文作者：Yang Li He Jie Ren Zhaoqiang Li Xiaoyan Xu Ke

单位：成都医学院第一附属医院呼吸与危重症医学科610500

英文单位：Department of Respiratory and Critical Medicine the First Affiliated Hospital of Chengdu Medical College Chengdu 610500 China

关键词：非小细胞肺癌；安罗替尼；Meta分析

英文关键词：Non-smallcelllungcancer；Anlotinib；Metaanalysis

• 摘要：

• 【摘要】目的    系统评价安罗替尼治疗晚期非小细胞肺癌（NSCLC）的效果和安全性。方法    计算机检索PubMed、Cochrane Library、EMbase、Web of science、万方数据库、维普数据库、中国学术期刊全文数据库，检索时限为2014年1月1日至2019年7月8日，检索所有关于安罗替尼治疗晚期NSCLC的文献，试验组患者给予安罗替尼或者安罗替尼联合常规治疗或联合其他药物治疗，对照组患者给予常规治疗或其他药物治疗。由2位研究者按照纳入和排除标准对文献进行筛选，并进行资料提取及方法学质量评价，采用Revman 5.2软件进行Meta分析。结果    共纳入5篇随机对照试验文献，695例NSCLC患者。Meta分析结果显示，试验组的疾病控制率优于对照组，差异有统计学意义（相对危险度=1.68，95%置信区间：1.08～2.60，P=0.02）；试验组无进展生存期及总生存期均高于对照组，差异有统计学意义（风险比=0.27、0.71，95%置信区间：0.22～0.32、0.59～0.85，均P＜0.05）；试验组高血压和腹泻发生率均高于对照组（均P＜0.001），2组肝功能异常、恶心呕吐、Ⅲ～Ⅳ级咯血发生率差异均无统计学意义（P=0.27、0.05、0.30）。结论    安罗替尼治疗晚期NSCLC患者临床效果较好，其发生高血压及腹泻的风险较高，其他不良反应如肝功能异常、恶心呕吐及Ⅲ～Ⅳ级咯血的发生率与对照组相近，患者总体耐受较好。

• 【Abstract】Objective    To systematically evaluate the efficacy and safety of anlotinib in treatment of advanced non-small cell lung cancer(NSCLC). Methods    Literatures of anlotinib treating NSCLC were searched in PubMed, Cochrane Library, EMbase, Web of Science, Wanfang Database, VIP Database and Chinese Journal Full-text Database from January 1st, 2014 to July 8th, 2019. The control group was treated with routine treatment. The experimental group was treated with anlotinib with or without other medication. Two researchers screened the literatures according to inclusion and exclusion criteria, extracted the data and evaluated the methodological quality. Revman 5.2 software was used for meta analysis. Results    Five randomized controlled trials involving 695 NSCLC patients were included. Meta analysis showed that the disease control rate in the experimental group was better than that in the control group, with a significant difference［relative risk=1.68, 95% confidence interval(CI): 1.08-2.60, P=0.02］; the progression-free survival and total survival in the experimental group were higher than those in the control group, with significant differences（hazard ratio=0.27, 0.71; 95%CI: 0.22-0.32, 0.59-0.85, both P＜0.05）. Incidences of hypertension and diarrhea in the experimental group were significantly higher than those in the control group（both P＜0.001）. There were no statistical differences in incidences of liver dysfunction, nausea and vomiting, grade Ⅲ-Ⅳ hemoptysis between groups（P=0.27, 0.05, 0.30）. Conclusions    Anlotinib is effective in treating advanced NSCLC, but it brings a high risk of hypertension and diarrhea. Other adverse reactions such as abnormal liver function, nausea and vomiting, grade Ⅲ-Ⅳ hemoptysis show equal incidences to the control group. The overall tolerance of patients is acceptable.