A Meta-analysis Of Cisplatin And Carboplatin Dual Chemotherapy Regimen On ⅢB/Ⅳ NSCLC

Objectives: In this paper,the efficacy and safety of cisplatin and carboplatin first-line dual drug chemotherapy in ⅢB ~ ⅣNSCLC patients were studied with meta comprehensive quantitative evaluation method,with a view to providing more reference for clinical work.Methods : In the Pubmed,Cochrane Library,Embase and other databases,the relevant literature from the database to December 2017 was retrieved.According to certain inclusion and exclusion criteria,the literature that meets the requirements is selected,and the study population is NSCLC(stage ⅢB ~ Ⅳ);The intervention measures for the combination of cisplatin or carboplatincombined with a thirddrugsfirst-line treatment ofⅢB ~ Ⅳ NSCLC.Main indicators: objective response rate(ORR),1-year survival rate(1-y OS)and adverse reactions(AE).Meta-analysis was used to analyze the quantitative analysis.Results: Finally 9 randomized controlled trials were included,including 3614 patients,1809 cisplatin group and 1805 carboplatin group.The ORR of cisplatin group was more advantages than that of carboplatin group(28.69% vs 23.32%,RR=1.23,95%CI: 1.10 to 1.37,P=0.0003).The 1-y OS was no difference between cisplatin group and carboplatin group(38.64% vs 35.62%,RR=1.08,95%CI: 1.00 to 1.18,P=0.06).Platelet reduction in cisplatin was lower than that in carboplatin group(5.32% vs 11.76%,OR=0.40,95%CI: 0.29 to 0.54,P<0.00001).There was no obvious advantage of cisplatin in the occurrence of anemia and neutrophil reduction compared with carboplatin group(P=0.47,P=0.83).The cisplatin group was more prone to nausea and vomiting than carboplatin group(P<0.00001).Severe diarrhea and nephrotoxicity are also more likely to occur in cisplatin group(P=0.02,P=0.03).No statistical difference was found in the adverse reactions,such as severe fatigue,anorexia.Conclusions: In the treatment of patients withⅢB ~ ⅣNSCLC,the double drug chemotherapy regimen containing cisplatin has a higher ORR than that of carboplatin;there was no obvious advantage in the 1-year survival rate of cisplatin compared with carboplatin.Analysis of adverse reactions in both groups showed that gastrointestinal reactions were more common in cisplatin group,while adverse reactions in the blood system were more common in carboplatin group.