title: Safety of irinotecan/cisplatin versus etoposide/cisplatin for patients with extensive-stage small-cell lung cancer: a metaanalysis.
abstract: OBJECTIVE
  The objective of this study was to evaluate the safety of patients with extensive small-cell lung cancer treated with irinotecan/cisplatin (IP) versus etoposide/cisplatin (EP).
  
  
  METHODS
  This is a metaanalysis of a randomized controlled trial. The main outcome measures for safety were grade 3/4 leukopenia, grade 3 anemia, grade 3/4 thrombocytopenia, grade 3/4 neutropenia, grade 3 vomiting/nausea, grade 3/4 diarrhea, and infection.
  
  
  RESULTS
  Three randomized controlled trials totaling 535 patients were included. Metaanalysis results are as follows: fewer patients receiving IP experienced grade 3/4 leukopenia (response rate [RR], 0.44; 95% confidence interval [CI], 0.29-0.67), grade 3 anemia (RR, 0.65; 95% CI, 0.43-0.99), and grade 3/4 thrombocytopenia (RR, 0.23; 95% CI, 0.12-0.42), compared with patients receiving EP. But more patients experienced grade 3 vomiting or nausea (RR, 2.27; 95% CI, 1.37-3.37) and grade 3/4 diarrhea (RR, 21.66; 95% CI, 4.87-96.2). There was no significant difference between the 2 groups with regard to infection (RR, 0.75; 95% CI, 0.54-1.04).
  
  
  CONCLUSIONS
  Current clinical studies might confirm that fewer patients receiving IP experienced grade 3/4 leukopenia, grade 3 anemia, grade 3/4 thrombocytopenia, and grade 3/4 neutropenia, compared with patients receiving EP, but more experienced grade 3 vomiting/nausea and grade 3/4 diarrhea. There was no significant difference between the group receiving IP and the group receiving EP with regard to infection. Although there is convincing evidence to confirm the results mentioned herein, they still need to be confirmed by large-sample, multicenter, randomized, controlled trials.
authors.affiliation: Evidence Based Medicine Center of Lanzhou University, Lanzhou City, Gansu Province, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Jiang
authors.forename: Ke-Hu
authors.initials: KH
authors.lastname: Yang
authors.forename: Deng-Hai
authors.initials: DH
authors.lastname: Mi
authors.forename: Ya-Li
authors.initials: YL
authors.lastname: Liu
authors.forename: Jin-Hui
authors.initials: JH
authors.lastname: Tian
authors.forename: Bin
authors.initials: B
authors.lastname: Ma
authors.forename: Ji-Ying
authors.initials: JY
authors.lastname: Tan
authors.forename: Zheng-Gang
authors.initials: ZG
authors.lastname: Bai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D018288:Carcinoma, Small Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003967:Diarrhea / Q000139:chemically induced; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D000077146:Irinotecan; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009367:Neoplasm Staging; D016032:Randomized Controlled Trials as Topic; D014839:Vomiting / Q000139:chemically induced
chemical_list: D005047:Etoposide; D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin