目的 評價卡培他濱+伊立替康與氟尿嘧啶/醛氫葉酸（5-FU/LV）+伊立替康治療轉移性結直腸癌的有效性和安全性。 方法 計算機檢索PubMed、CENTRAL、Embase、中國生物醫學數據庫、中國期刊全文數據庫、維普數據庫和萬方數據庫，檢索時間均從建庫至2011年9月。對符合納入標準的隨機對照試驗進行質量評價和Meta分析。 結果 納入3個隨機對照試驗，共計419例患者，卡培他濱+伊立替康在中位生存期、完全緩解率[RR=1.58，95%CI（0.27，9.11），P=0.61]、部分緩解率[RR=0.86，95%CI（0.68，1.09），P=0.20]、總有效率[RR=0.88，95%CI（0.71，1.09），P=0.26]上表現出與5-FU/LV+伊立替康相似的效果，安全性方面卡培他濱+伊立替康有較高的Ⅲ/Ⅳ級惡心[RR=1.92，95%CI（1.05，3.54），P=0.04]、腹瀉[RR=3.23，95%CI（2.14，4.89），P＜0.000 01]發生風險和較低的Ⅲ/Ⅳ級中性粒細胞減少[RR=0.72，95%CI（0.53，0.98），P=0.04]發生風險。 結論 根據當前現有證據，5-FU/LV+伊立替康可能較卡培他濱+伊立替康更為有利于轉移性結直腸癌患者的治療，但仍需結合臨床實際情況進行化療方案的優選。
ObjectiveTo systematically review the efficacy and safety of crizotinib in the treatment of non-small cell lung cancer (NSCLC).MethodWe electronically searched databases including the Cochrane Library (Issue 5, 2017), PubMed, Embase, China Biology Medicine Database, China National Knowledge Internet Database, VIP Database and Wangfang Data from the establishment to May 2017. The randomized controlled trials (RCTs), non-RCTs, case series and case reports on crizotinib for NSCLC were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, assessed the methodological quality of included studies, then make Meta-analysis and descriptive analysis.ResultA total of 15 studies were included, including 4 RCTs, 1 non-RCT, 4 case series and 6 case reports. The results indicated that the progression-free survival time of crizotinib group was 8 months, which was better than chemotherapy group (4.6 months). The results of Meta-analysis showed that the response rate in the crizotinib group was higher than that in the chemotherapy group [RR=2.35, 95%CI (1.59, 3.46), P<0.000 1]. The one year survival rate in the crizotinib group was 74.5%-78.6%. The incidences of adverse reactions including dysopsia, dysgeusia, diarrhea, vomiting, constipation, transaminase lifts, upper respiratory tract infection, edema and dizziness in the crizotinib group were higher than those in the chemotherapy group (P<0.05), while the incidences of adverse reactions including leukopenia, thrombocytopenia, alopecia and fatigue in crizotinib group were lower than those in the chemotherapy group (P<0.05). Subgroup analysis under precision treatment showed the progression-free survival time of anaplastic lymphoma kinase (ALK)-positive group was 8 months, and it was longer than ALK-negative group of 4 months.ConclusionsBased on current evidence, crizotinib is better than chemotherapy for NSCLC. Due to limited quality of the included studies, the above conclusion needs to be verifed by more high quality studies.