1、受试者均自愿签署知情同意书。1.2.3干预措施试验组:恩度联合以铂类为基础复筛排除不符合纳入标准的文献（n =37初检获得相关文献 （n =214初筛后获得文献（n =55最终纳入文献（n =18排除明显不符合纳入标准的文献 （n =159图1 文献筛选流程及结果表1 纳入研究的基本特征纳入研究例数（T/C 平均年龄（岁（T/C 肿瘤分期（T/C ,例干预措施结局指标期期TC 刘永煜2005533/1754.64/53.8513/209/8恩度7.5 mg/m 2 + NP NP RR 、CBR 王金万20056322/16457/55137/75185/89恩度7.5 mg/m 2 + NP
2、 NP RR 、TTP 、CBR 蔡莉20072239/3266/6923/1916/13恩度15 mg/d + NP NP RR 陈绍俊20082324/2658/57共50恩度15 mg/d + NO NO CBR陈兴秀20092433/17未报道共50恩度15 mg/d + NX NX RR 、CBR 、不良反应陈永倖20102530/25502/493共55恩度15 mg/d + GP GP RR 、CBR 高馨20102636/29均为55共37共28恩度7.5 mg/m 2 + GP/NP GP/NP RR 、CBR顾洪兵20102727/27均为50共32共22恩度7.5 mg/
3、m 2 + NP NP RR 、CBR 、TTP 和毒副反应韩立春20092837/31未报道20/1817/13恩度15 mg/d + TP TP RR金军20092915/25均为5173共40恩度15 mg/d + NP NP RR 、毒副反应师广勇200930308/154均为54共236共226恩度7.5 mg/m 2 + GP GP RR 、CBR 、TTP 和毒副反应王季颖20093117/1863/645/612/12恩度7.5 mg/m 2 + NP NP RR 、TTP 、CBR 王晋20103218/18均为57.5共36恩度15 mg/d + TP TP RR 和不良反
4、应王蕾20103327/2958 /5615/1712/12恩度7.5 mg/m 2 + NP NP RR 、CBR 和不良反应魏启宏20103416/16均为59.8共5共27恩度15 mg/d + GP GP RR 、DCR 、毒性反应徐登飞20093525/26均为63共29共22恩度7.5 mg/m 2 + DP DP RR张特20093648/5652/5328/3020/26恩度7.5 mg/m 2 + GP GP RR 、CBR 、QOL 顾颖20103727/33均为53.6共28共32恩度15 mg/d + GPGPRR 和不良反应T :试验组;C :对照组;NP :长春瑞滨
5、+顺铂;TP :紫杉醇+顺铂;GP :吉西他滨+顺铂;DP :多西他赛+顺铂;NX :长春瑞滨+奈达铂;NO :长春瑞滨+奥沙利铂;RR :有效率;TTP :肿瘤进展时间;CBR :临床受益率;DCR :疾病控制率;QOL :生活质量。Random sequence generation （selection biasAllocation concealment （selection bias Blinding of participants and personnel （performance biasBlinding of outcome assessment （detection bia
6、sIncomplete outcome data （attrition biasSelective reporting （reporting biasOther bias0%25%50%75%100%Low risk of biasUnclear risk of bias High risk of bias图2 偏倚风险比例图:作者对所有纳入研究产生偏倚风险的项目所占百分比的判断R a n d o m s e q u e n c e g e n e r a t i o n （s e l e c t i o n b i a s 20055+ 200930+ 200936 上200935+ 200
7、931+ 20103220103320056+200722 200929 200924201025200823+ 200928 201027201037倄仔201026偻 201034A l l o c a t i o n c o n c e a l m e n t （s e l e c t i o n b i a s +?B l i n d i n g o f p a r t i c i p a n t s a n d p e r s o n n e l （p e r f o r m a n c e b i a s B l i n d i n g o f o u t c o m e a s
8、s e s s m e n t （d e t e c t i o n b i a s I n c o m p l e t e o u t c o m e d a t a （a t t r i t i o n b i a s +S e l e c t i v e r e p o r t i n g （r e p o r t i n g b i a s +O t h e r b i a s图3偏倚风险图:作者对所有纳入研究中每个偏倚风险项目的判断01+GP GP .vs 362009 302009 320107 342010 252010Subtotal （95%CITotal eventsHet
9、erogeneity:=1.48,df =4（=0.83;=0%P I Test for overall effect:=5.21（0.00001Z P 02+NP NP vs . 52005 20056 222007 292009 312009 332010 27=2.11,df =6（=0.91;=0%P I Test for overall effect:=4.42（0.0001Z P 03+TP TPvs . 322010 282009Subtotal （95%CI=0.01,df =1（=0.91;=2.30（=0.02Z P 04+DP DP vs . 35200905+NX NX
10、vs . 2406+NO NOvs . 23200807+GP/NP GP/NP vs . 262010Total （95%CI=5.48,df =17（=1.00;=7.76（0.00001Z P Test for subgroup differences:=1.69,df =6（=0.95,=0%P I 16111139161651411422531012180*23141243748308271630429303223915162726475183*4361077830556546321041610696101686871685615433162528417164322515292630
11、818314926172629739 3.8%20.8%2.3%2.6%3.4%33.0%4.0%22.0%5.7%1.6%0.5%3.0%5.2%42.0%3.1%5.7%8.8%4.1%4.1%4.0%4.0%100.0%2.33 1.10,4.97（1.85 1.30,2.64（3.18 1.30,7.79（1.800.77,4.19（2.22 1.03,4.82（2.03 1.56,2.66（1.320.63,2.80（1.81 1.29,2.56（1.81 1.01,3.23（2.080.66,6.57（2.810.33,24.16（1.790.75,4.26（1.200.63,2.
12、27（1.71 1.35,2.17（1.670.77,3.61（1.760.98,3.15（1.73 1.08,2.75（1.560.77,3.16（1.97 1.00,3.91（1.900.97,3.70（1.380.62,3.05（1.82 1.56,2.11（Study or Subgroup Events Total Events Total Weight M-H,Fixed,95%CI Risk Ratio Risk Ratio M-H,Fixed,95%CI0.0010.11101000图4 恩度联合化疗与单纯化疗治疗非小细胞肺癌总有效率比较的Meta 分析01+GP GP vs
13、. 362009 302009 252010 320107 34=13.92,df =4（=0.008;=71%P I Test for overall effect:=4.82（0.00001Z P 02+NP NP vs . 20056 52005222007 312009 292009 272010 33=2.96,df =6（=0.81;=2.63（=0.009Z P 03+TP TP2009Subtotal （95%CI=0.03,df =1（=0.86;=1.20（=0.23Z P 04+DP DP vs . 35=28.09,df =17（=0.04;=39%P I Test f
14、or overall effect:=6.18（=10.08,df =6（=0.12,=40.5%P I 36227292314329236253712522203571735522226222783548308302716429322303916152627475183*4361077169919191216510515271052018200162743177*615425331628416417321525262930818314926172629739 2.7%24.1%3.8%3.1%2.2%35.9%25.4%3.5%5.4%1.9%0.7%3.7%3.2%43.7%2.9%5.4
15、%8.3%3.0%1.7%3.9%3.4%100.0%2.63 1.68,4.10（1.15 1.00,1.31（1.27 1.01,1.60（1.48 1.06,2.06（1.170.83,1.64（1.30 1.17,1.45（1.14 1.00,1.31（0.940.75,1.20（1.120.95,1.33（1.130.71,1.78（1.670.58,4.82（1.100.84,1.44（1.190.83,1.71（1.13 1.03,1.24（1.060.87,1.30（1.090.93,1.27（1.080.95,1.22（1.350.98,1.84（1.91 1.06,3.47
16、（1.080.88,1.33（1.280.89,1.83（1.21 1.14,1.29（0.10.20.512510图5 恩度联合化疗与单纯化疗治疗非小细胞肺癌临床受益率比较的Meta 分析01+GP GPvs . 36302009 252010 342010 320107Subtotal （95%CI=13.99,df =4（=0.007;=71%P I Test for overall effect:=3.02（=0.003Z P 02+NP NP.vs 52005 222007 31=2.81,df =2（=0.25;=29%P I Test for overall effect:=1.
17、12（=0.26Z P 03+TP TP .vs 322010 28=0.73,df =1（=0.39;=0.16（=0.87Z P 04+DP DP .vs 35200905+NO NO.vs 23Total （95%CITotal events Heterogeneity:=20.61,df =11（=0.04;=47%P I Test for overall effect:=2.77（=0.006=3.12,df =4（=0.54,P I 431598131623921351571172239111337348308301627429303916851837552524618461077
18、14201941530135816203612123125615425163328417321564183*4912.1%40.6%2.2%4.0%5.1%64.0%5.5%9.4%3.8%18.7%4.6%6.2%10.7%3.3%3.3%100.0%1.090.93,1.27（0.740.64,0.86（0.950.40,2.26（0.930.69,1.25（0.980.64,1.48（0.850.76,0.94（0.790.59,1.06（0.960.83,1.10（1.080.85,1.37（0.930.83,1.05（1.060.87,1.30（0.920.63,1.34（0.980
19、.78,1.23（0.950.52,1.75（1.170.67,2.04（0.890.82,0.97（Study or Subgroup Events TotalEvents TotalWeight M-H,Fixed,95%CIRisk RatioM-H,Fixed,95%CI0.20.5125图6 恩度联合化疗与单纯化疗治疗非小细胞肺癌白细胞减少症发生率比较的Meta 分析.vs 30362009 320107 252010 34=2.63,df =4（=0.62;=2.16（=0.03Z P 02+NP NP .vs 20056 52005 222007 312009 33=4.99,d
20、f =4（=0.29;=20%P I Test for overall effect:=0.48（=0.63Z P 03+TP TP .vs 28200904+DP DP.vs 35200905+NO NO .vs 23Total （95%CITotal events=17.49,df =12（=0.13;=31%P I Test for overall effect:=1.67（=0.10=6.30,df =4（=0.18,=36.5%P I 626748875144546835952043084827301642932630391627438372524953487929752575344427114161154563325162841671732152926031262662734.0%3.4%4.3%1.2%4.8%47.7%17.6%4.7%2.9%1.6%2.0%28.9%15.6%5.7%2.0%100.0%0.650.47,0.89（1.000.36,2.77（0.950.41,2.22（1.670.33,8.36（0.890.46,1.71（0.750.58,0.97（1.050.67,1.62（0.320.11,0.95
