[A meta analysis of doublets versus single-agent chemotherapy for elderly patients with advanced non-small cell lung cancer].
OBJECTIVE
It remains disputed whether doublets are more effective than single-agent chemotherapy for elderly patients with advanced non-small cell lung cancer (NSCLC). The aim of this study is to evaluate the efficacy and safety of doublets and single-agent chemotherapy for elderly patients with NSCLC.


METHODS
Data from all published, randomized trials that compared doublets and single-agent chemotherapy in elderly patients were collected from electronic databases (PubMed, EMBASE, Cochrane Library, CNKI and the CBMdice). Meta-analysis was completed using software Stata 11.0.


RESULTS
The results of the meta-analysis, including 12 eligible trials (2,306 patients), showed that the doublets significantly increased the overall response rate (OR=1.80, 95%CI:1.50-2.17, P<0.000,1) and one-year survival rate (OR=1.45, 95%CI: 1.22-1.72, P<0.000,1) compared with single-agent chemotherapy. The results of one-year survival rate in platinum-based doublet chemotherapy arms (OR=1.55, 95%CI: 1.18-2.03, P=0.001) and non platinum-based ones (OR=1.38, 95%CI: 1.10-1.73, P=0.006) were both significantly higher than that of single-agent chemotherapy. However, grade 3/4 anemia, neutropenia, thrombocytopenia and neurotoxicity (P<0.05) were significantly associated with doublet chemotherapy. The incidence of toxicity effect in non platinum-based chemotherapy was similar to that of single-agent chemotherapy.


CONCLUSIONS
Compared with single-agent chemotherapy, doublet chemotherapy could increase the overall response rate and one-year survival rate significantly. Therefore, doublet chemotherapy would be more appropriate for elderly patients with advanced NSCLC as the first-line chemotherapy regimen. However, further prospective randomized controlled trials in elderly NSCLC patients is needed to verify the findings in this study.
Department of Oncology, the Fourth Affiliated Hospital, China Medical University, Shenyang 110032, China. cmu4h-xca@126.com
Chong'an
C
Xu
Ziyou
Z
Chang
Xiaojie
X
Wang
Lin
L
Li
Haiyan
H
Qi
Yan
Y
Liu
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D015996:Survival Rate
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds