目的 系統(tǒng)評價甲磺酸阿帕替尼治療晚期非小細胞肺癌（NSCLC）的有效性和安全性。方法 計算機檢索Cochrane圖書館、Embase、PubMed、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫（CBM）、中國期刊全文數(shù)據(jù)庫（CNKI）、維普數(shù)據(jù)庫（VIP）、萬方數(shù)據(jù)庫等關(guān)于甲磺酸阿帕替尼治療晚期NSCLC的臨床隨機對照試驗（RCT），檢索時間均從各數(shù)據(jù)庫創(chuàng)建至2021年6月。由兩名評價員獨立評價文獻質(zhì)量、提取資料并交叉核對，并進行方法學(xué)質(zhì)量評價，采用RevMan 5.2軟件進行Meta分析。結(jié)果 共納入17項RCTs，包括1 263例患者，其中治療組638例、對照組625例。Meta分析結(jié)果顯示：甲磺酸阿帕替尼組總有效率[RR=1.48，95% CI （1.36，1.62）]，細胞角蛋白19片段[RR=-1.50，95% CI （-1.75，-1.25）]、血清癌胚抗原[RR=-4.05，95% CI （-4.30，-3.80）]、基質(zhì)金屬蛋白酶-9[RR=-401.98，95% CI （-438.82，-365.13）]、血管內(nèi)皮生長因子[RR=-192.54，95% CI （-211.55，-173.53）]，與對照組比較均有顯著性差異（P<0.000 01）；治療組消化道不適、蛋白尿、白細胞降低以及口腔黏膜炎的發(fā)生危險度高于對照組，但差異無統(tǒng)計學(xué)意義。結(jié)論 基于現(xiàn)有臨床證據(jù)，甲磺酸阿帕替尼治療晚期NSCLC較對照組療效更為顯著，是一種較為理想的用藥方案。

Objective To systematically evaluate efficacy and safety of apatinib mesylate for advanced non-small cell lung cancer (NSCLC), for which to provide scientific proofs for clinical decision making. Methods The databases including: The Cochrane Library, Embase, PubMed, CNKI, CBM, VIP, Wanfang Data were searched from the inception to Jun 2021 to collect the randomized controlled trials (RCTs) related to the safety and efficacy of apatinib mesylate for the treatment of advanced NSCLC. Quality assessment and data extraction were conducted by two reviewers independently. Disagreement was resolved through discussion. and data analyses were performed with RevMan 5.2 software. Results A total of 17 RCTs were included, including 1 263 patients. There were 638 patients in treatment groups and 625 patients in the control group. The Meta-analysis results showed, compared with the control group, the total effective rate [RR = 1.48, 95%CI (1.36, 1.62)], cytokeratin-19-fragment [RR = -1.50, 95%CI (-1.75, -1.25)], carcinoembryonic antigen [RR=-4.05,95%CI(-4.30,-3.80)],matrix metalloproteinase-9 [RR = -401.98, 95%CI (-438.82, -365.13)], vascular endothelial growth factor [RR = -192.54, 95%CI (-211.55, -173.53)] were significantly different in apatinib mesylate group (P < 0.000 01). The risk of gastrointestinal discomfort, proteinuria, leukopenia and oral mucositis in the treatment group was higher than that in the control group, but the difference was not statistically significant. Conclusion Based on the present clinical evidence, the Meta-analysis results indicate that the treatment efficacy of apatinib mesylate group is better than control group on treating advanced NSCLC, which is a standard treatment of advanced non-small cell lung cancer.

R979.1

戰(zhàn)略支援部隊特色醫(yī)學(xué)中心醫(yī)藥衛(wèi)生基礎(chǔ)研究探索課題（19ZX63）