Abstract: Objective To assess the efficacy and safety of irinotecan plus platinum（IP） compared with etoposide plus platinum（EP） regimens in patients with extensive small cell lung cancer（ED-SCLC）. Methods We searched the Cochrane Library， Pubmed， Medline， CBM，CNKI，CBM and WanFang databases to collect the randomized controlled trials，in which IP regimen was compared with EP regimen as the first-line treatment of ED-SCLC published before May 2014. RevMan 5.2 software was used for meta-analysis. Results Nine studies involving 2229 patients were included. The result of meta-analysis showed that in patients with ED-SCLC， IP regimen was better than EP regimen in one-year survival rate（OR=1.32， 95%CI： 1.10~1.58， P=0.003） and there was no significant difference between the both groups in the effective rate（OR=1.13， 95%CI：0.90~1.41， P=0.29）. In the aspect of safety， the major adverse event for IP was more digestive toxicities， whereas EP was associated with more hematologic toxicities. Conclusion IP regimen shows more superiority and can be used as the first-line drug for ED-SCLC，who intoleranced to hematologic toxcities.