伊立替康联合铂类治疗广泛期小细胞肺癌的循证评价

Evidence-based Evaluation of Irinotecan Combined with Platinum in the Treatment of Extensive Small Cell Lung Cancer

关键词:  伊立替康  铂类  小细胞肺癌  超说明书用药  循证评价

Key words:  irinotecan  platinum  small cell lung cancer  off-label drug use  evidence-based evaluation

摘要:

目的 循证评价伊立替康联合铂类治疗广泛期小细胞肺癌超说明书用药的合理性。方法 查询国内外伊立替康的最新版药品说明书，收集伊立替康的全部适应证。计算机检索PubMed、Cochrane Library、Epistemonikos、EMbase、CBM、CNKI和万方数据库，检索时限为从建库至2018年11月，收集伊立替康治疗广泛期小细胞肺癌的相关指南与系统评价，对该方案治疗广泛期小细胞肺癌的有效性和安全性进行分析评价。结果 FDA说明书提及伊立替康用于广泛期小细胞肺癌，但NMPA说明书未提及；国内外共有4篇指南推荐伊立替康联合铂类治疗广泛期小细胞肺癌，5篇系统评价对铂类联合伊立替康与依托泊苷进行分析，认为铂类联合伊立替康可作为广泛期小细胞肺癌的一线治疗方案，但要警惕不良反应的发生。结论 目前有关铂类联合伊立替康治疗广泛期小细胞肺癌的证据较充分，可作为广泛期小细胞肺癌的治疗用药。

Abstract:

OBJECTIVE To systematically evaluate the rationality of irinotecan combined with platinum in the treatment of extensive small cell lung cancer(SCLC). METHODS Searched the latest edition of the drug instructions at home and abroad, and collected all indications of irinotecan. PubMed, Cochrane Library, EMbase, Epistemonikos, CBM, CNKI and Wanfang database were searched from database foundation to November 2018. Collected the relevant guidelines and systematic reviews of irinotecan in the treatment of extensive SCLC, and to systematically evaluate the efficacy and safety of irinotecan in the treatment of extensive SCLC. RESULTS The FDA manual mentions that irinotecan was used for extensive SCLC, but the NMPA manual did not mention. There were four guidelines recommending irinotecan combined with platinum in the treatment of extensive SCLC. Five systematic reviewed analyzed platinum combined with irinotecan or etoposide. It was generally believed that platinum combined with irinotecan could be used as a first-line treatment for extensive SCLC, but the occurrence of adverse reactions should be vigilant. CONCLUSION At present, there is sufficient evidence about platinum combined with irinotecan in the treatment of extensive SCLC, which can be recommended as a treatment for extensive SCLC.