Meta Analysis On The Application Of KLT Adjuvant Chemotherapy In Lung Cancer

Objective: The efficacy and safety of systematic evaluation of Kanglaite adjuvant chemotherapy of lung cancer,combined with analysis of Kanglaite Injection were assisted Changchun platinum,gemcitabine plus platinum and paclitaxel plus platinum chemotherapy in the treatment of lung cancer efficacy and safety evaluation system,efficiency,reducing toxicity,to provide clinical basis for the treatment of lung cancer to formulate a reasonable strategy.Methods: Respectively,Wanfang,VIP,CNKI,CBM,Pubmed,Cochrane,Library,EMBASE and SCI,Chinese clinical trials registry database,American clinical trial registry database,using Cochrane RCT evaluation to evaluate the quality standard of the quality of the included studies and Meta analysis data extraction.Result:1)Kanglaite combined with NP regimen: a total of 35 RCT,2634 cases of lung cancer patients,study the general quality;a comparison with the NP: ORR,DCR,1years of long-term efficacy,quality of life,reduce the white blood cell and platelet decrease,bone marrow suppression,gastrointestinal reactions,nausea and vomiting,phlebitis and alopecia in Meta analysis with the R value of D was 0.14（0.10 0.17）,0.09（0.05 0.12）,1.69（1.07 2.68）,0.25（0.20 0.29）,-0.22（-0.27--0.17）,-0.09（-0.14 ^-0.04）,-0.43（-0.53 ^-0.34）,-0.26(-0.33 ^-0.19,-0.12 ^-0.18-0.06),0.13（0.07 0.19）,-0.16（-0.26 ^-0.07）,the differences were all statistically significant;immune indexes of CD3+ cells,CD4+ cells,CD8+ cells,CD4+/CD8+ cells,NK cells and Meta analysis of the SMD value is 2.34（1.02 3.67）,1.85（from 1.61 to 2.10）,0.68（0.45 0.92）,0.69（0.28 1.09）,2.29（1.39 3.19）,were statistically significant;anemia,liver injury,renal injury,heart function damage,neurotoxicity Meta analysis combined RD was-0.03（-0.09⁰.03）、-0.03（-0.09⁰.03）-0.02（-0.06⁰.01）-0.03（-0.06^-0.01）、-0.06（-0.15^-0.04）,there was no significant difference;the decrease of ORR,DCR,quality of life,leukopenia,nausea and vomiting,platelet publicationbias little.2)Kanglaite combined with GP regimen: a total of 30 RCT,2150 cases of lung cancer patients,study the general quality;a comparison with the GP: ORR,DCR,1years,2 years of long-term curative effect of long-term efficacy,quality of life,leukopenia,anemia,bone marrow suppression,gastrointestinal reactions,nausea and vomiting,liver function damage,hair loss,skin itching and Meta analysis of the value of RD was 0.17（0.13 0.21）,0.13（0.09 0.17）,1.69（0.02 0.22）,0.23（0.18 ⁰.28）,1.59（0.97 2.21）,-0.09（-0.15 ^-0.02）,-0.10（0.17 ^-0.03）,-0.29（-0.39 ^-0.19）,-0.15（-0.23 ^-0.08）,-0.10（-0.15 ^-0.04）,-0.11（-0.17 ^-0.04）,-0.27（-0.38 ^-0.16）,were statistically significant;immune index of CD3+ cells,CD4+ cells,CD8+cells and CD4+/CD8+ Meta analysis with SMD value 1.64（0.99 2.30）,0.65（0.48 ⁰.83）,0.69（0.50 0.88）,-0.19（-0.24 ^-0.13）,were statistically significant;2 years of long-term efficacy,renal injury,heart function damage,neurotoxicity,pruritus Meta analysis of combined RD value is 0.12（-0.09 0.33）,-0.03（-0.08 0.03）,0.04（-0.02 0.09）and-0.02（-0.13 0.10）,-0.08（-0.19 0.03）,there were no statistical significance;ORR,DCR,quality of life,leukopenia,nausea and vomiting were not publicationbias.3)Kanglaite combine TP regimen : 22 RCT into the 1681 cases of lung cancer patients,study the general quality;a comparison with the TP: ORR,DCR,quality of life,leukopenia,anemia,bone marrow suppression,nausea and vomiting reaction Meta analysis combined with RD value of 0.13（0.08 0.17）,0.15（0.11 0.19）,0.27（0.22 0.33）,0.72（-0.39 ^-0.13）,-0.34（-0.50 ^-0.17）;immune index of CD3+ cells,CD4+ cells,CD4+/CD8+ cells,NK cells and Meta analysis of the SDM value is 0.59（0.38 0.79）,1.03（0.56 1.50）,-0.24（-0.32 ^-0.17）,-0.05（-0.15 0.04）,were statistically significant,CD8+ cell Meta analysis with SDM value is-0.06（-0.37 ⁰.25）,no statistical significance;1 years of long-term curative effect,reduce platelet,gastrointestinal reaction,liver function,renal function damage,heart damage Work injury,fever,hair loss,phlebitis Meta analysis combined with RD value of 0.92（0.69 1.24）,0.56（0.36 0.76）,0.80（0.40 1.20）,-0.02（-0.13 0.08）,0.04（-0.06 0.14）and-0.04（-0.13 0.04）;ORR,DCR,quality of life the publication bias was not.Conclusion:1 Kanglaite as an assistant chemotherapy drugs have synergistic and attenuated effect of combined with NP regimen in treatment of lung cancer;2 Kanglaite combined with GP chemotherapy for lung cancer,can reduce the adverse reactions and increase curative effect;3 Kanglaite combined with TP regimen for lung cancer,application of effective evaluation index,the safety and efficacy of good.