体部伽玛刀联合介入化疗栓塞治疗中晚期肝癌的meta分析  

Meta-analysis of SBRT combined with tace for advanced hepatocellular carcinoma

作　　者：党亚正[1] 王国栋[1] 陆婉玲[1] 李迎春[1] 卫伟[1] 

机构地区：[1]解放军第323医院综合内科,陕西西安710054

出　　处：《西部医学》2014年第4期430-434,共5页Medical Journal of West China

基　　金：陕西省自然科学基金(CWS105B07)

摘　　要：目的系统评价体部伽玛刀(Stereotactic Body Radiation Therapy,SBRT)联合介入化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗中晚期原发性肝癌的疗效及安全性,为临床决策提供循证医学依据。方法计算机检索Cochrane Library、PubMed、CBM、CNKI、VIP、WanFang Data等数据库,收集所有伽玛刀联合TACE治疗中晚期肝癌比较单纯TACE治疗的随机对照试验(RCT),提取文献资料和评价纳入研究质量,以软件RevMan5.1进行Meta分析。结果共纳入11篇文献,共1115例患者。Meta分析结果显示:伽玛刀联合TACE组与单纯TACE组相比,其1、2年生存率、总有效率的差异均有统计学意义(P<0.05),两组副反应差异无统计学意义(P>0.05)。结论超级伽玛刀联合介入化疗栓塞与单纯TACE组相比,能明显提高中晚期肝癌患者的近期疗效和1年、2年生存率,联合治疗组副作用并未加重。联合治疗远期疗效还有待开展更多高质量、大样本的RCT实验加以验证。Objective In order to provide physicians with support of evidence-based medcine in clinical practice,we assessed the clinical efficacy and safety of Gamma-knife combined with transcatheter arterial chemoembolization （TACE） for intermediate-advanced-stage hepatocellular carcinoma （HCC）.Methods All of the references,publication date from 1989 to 2013,concerning such subject were searched in databses including Cochrane Library,PubMed,EMbase,CBM,CNKI,VIP.Quality of references was evaluated according to Cochrance Handbook4.2.6,and meta-analysis were conducted by RevMan 5.1 software.Results Eleven randomized controlled trails （RCT） including 1115 patients were enrolled in such meta analysis,results revealed that survival rates of 1,2 and 3 year in combination group were more higher than that of in TACE group.The side effects in two groups have no significant difference.Conclusion TACE combined with Gamma knife can improve long-term survival rate and short-term curative effect comparing with TACE group,while its long-term curative effect and safety still needs to be further verified in meta-analysis with more large sample and high quality RCTs.

关 键 词：肝细胞癌 体部伽玛刀 介入化疗栓塞术 META分析 

分 类 号：R735.7[医药卫生—肿瘤]