A meta-analysis of paclitaxel-based chemotherapies administered once every week compared with once every 3 weeks first-line treatment of advanced non-small-cell lung cancer

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• 作者：Guanghui Gao^a ; ^{ghgao103@hotmail.com} ; Haiqing Chu^a ; ^{chuhaiqing2139@163.com} ; Lan Zhao^a ; Tao Gui^a ; Qinghua Xu^a ; Jianping Shi^b
• 关键词：Carcinoma ; Non-small-cell lung ; Paclitaxel ; Weekly schedule ; Meta-analysis
• 刊名：Lung Cancer
• 出版年：2012
• 期刊代码：187_01695002
• 类别：med
• 出版时间：June, 2012
• 卷：76
• 期：3
• 页码：380-386
• 文件大小：320 K

摘要

Objective

The published data on the curative effects of comparing the once weekly paclitaxel-based chemotherapies (W-paclitaxel) with the standard every 3 weeks paclitaxel-based chemotherapies (S-paclitaxel) in the first-line treatment of advanced non-small-cell lung cancer (NSCLC) were still controversial. To derive a more precise estimation of the two regimens, a meta-analysis was performed.

Methods

Medical databases and conference proceedings were searched for randomized controlled trials which compared W-paclitaxel with S-paclitaxel in patients with first-line treatment of advanced NSCLC. The following keywords were used: 鈥減aclitaxel鈥? 鈥渨eekly schedule鈥?and 鈥渘on-small cell lung cancer鈥? Reference lists of original articles and review articles were also examined. The published languages and years were not limited. Endpoints were overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and adverse events. Statistical tests for heterogeneity were one-sided; statistical tests for effect estimates were two-sided.

Results

Five eligible trials involved 940 patients were identified. They were all published as full-text articles. The intention to treatment (ITT) analysis demonstrated that the ORR of W-paclitaxel regimens patients was 30.89%(143/463), whereas the ORR of S-paclitaxel regimens patients was 27.09%(123/454). The overall pooled relative ratio (RR) for ORR was 1.24 (95%confidence intervals (CI) = 0.93-1.66; P = 0.14) when W-paclitaxel regimens patients were compared with S-paclitaxel regimens patients. Although the patients with W-paclitaxel regimens had an similar OS and PFS in comparison with S-paclitaxel regimens (median OS was 9.8 versus 10.7 months; hazard ratio (HR) = 1.00; 95%CI = 0.86-1.17; P = 0.99; median PFS was 5.2 versus 4.7 months; HR = 0.90; 95%CI = 0.79-1.03; P = 0.13, respectively), the W-paclitaxel regimens led to significantly less frequent adverse events of hematological toxicities and nonhematological toxicities.

Conclusion

These results suggest that the W-paclitaxel is not superior than S-paclitaxel regimens. The paclitaxel-based chemotherapies given by every 3 weeks are still standard regimens. For patients, especially for the elder or the people with poor conditions who cannot tolerate the standard regimen, the weekly schedule can be considered.