| Background and objective: In patients with advanced non-small cell lung cancer(NSCLC) older than60years, the benefit-to-risk ratio of Platinum-based doublet vs.non-Platinum single-agent is not established. The aim of this study is to evaluate theefficacy and safety of these two kinds of chemotherapy. Methods: Randomized controlledtrials (RCTs) on Platinum-based doublet vs. non-Platinum single-agent for elderly patientswith advanced NSCLC were searched in PubMed, EMbase, Cochrane Library, CNKI,CBMdice. Meta-analysis were performed with RevMan5.2software. Results: Amongthe12RCTs involving753cases included. Meta-analysis showed that: compared with thenon-Platinum single-agent chemotherapy, Platinum-based doublet chemotherapy couldincrease the objective response rate（RR=1.37,95%CI:1.12-1.69, P=0.002）but there wereno significant differences between the two groups in1-year overall survival rate（RR=1.07,95%CI:0.91-1.27, P=0.41）; Grade3/4leukopenia, neutropenia, thrombocytopenia andnausea/vomiting were significantly more frequent with doublets. Conclusion: Comparedwith non-Platinum single-agent chemotherapy, Platinum-based doublet chemotherapycould increase the objective response rate, but not1-year overall survival rate. Theyinduced significantly more frequent Grade3/4hematologic toxicities and nausea/vomiting.The benefit-to-risk ratio of non-Platinum single-agents in elderly with advanced NSCLCmight be more favorable than that of doublets. However, further prospective randomizedcontrolled trials in elderly NSCLC is needed to verify the findings in this study. |
