肝动脉化疗栓塞联合索拉非尼治疗中晚期肝细胞癌近期疗效的Meta分析  

Meta analysis of curative effect of advanced hepatocellular carcinoma treated by artery embolism chemotherapy combined with Sorafinib

作　　者：韩继祥[1] 范宁[1] 陈茂盛[1] 曹宏泰[1] 焦作义[1] 

机构地区：[1]兰州大学第二医院,甘肃兰州730030

出　　处：《中国现代医药杂志》2014年第8期1-8,共8页Modern Medicine Journal of China

摘　　要：目的评估肝动脉化疗栓塞(TACE)联合索拉非尼与单独肝动脉化疗栓塞两种治疗方案对中晚期肝癌的疗效。方法计算机检索中国知网、万方、Medline、Embase、Cochrane library数据库,其他途径辅助查找发表的肝动脉化疗栓塞联合索拉非尼治疗中晚期肝癌的的文献。统计指标包括:1年生存率、治疗有效率(RR)、疾病控制率(DCR)、用药前后VEGF变化率、不良事件发生率(消化道症状、手足综合征、高血压),将统计结果分别纳入TACE联合索拉非尼组(T+S组)和TACE组(T组),通过Reviews 5.2软件进行数据分析。结果纳入随机对照研究共6篇(360例),男∶女=2.96∶1,T+S组269例,T组91例。1年生存率比较有统计学意义[OR=4.06,95%CI:(1.62,10.20),P<0.05];治疗有效率比较有统计学意义[OR=2.11,95%CI:(1.30,3.44),P<0.05)];疾病控制率有统计学意义[OR=4.52,95%CI:(2.69,7.58),P<0.05];用药前VEGF变化率无统计学意义[WMD=0.00,95%CI:(-0.37,0.37),P=1.00],用药后VEGF变化率有统计学意义[WMD=-1.23,95%CI:(-1.64,-0.82),P<0.05)];用药前后T+S组VEGF变化率有统计学意义[WMD=0.96,95%CI:(0.56,1.36),P<0.05],用药前后T组VEGF变化率无统计学意义[WMD=-0.23,95%CI:(-0.61,0.14),P>0.05];消化道症状发生率无统计学意义[OR=1.57,95%CI:(0.81,3.03),P>0.05];手足综合征发生率有统计学意义[OR=14.83,95%CI:(3.84,57.25),P<0.05];高血压发生率有统计学意义[OR=3.28,95%CI:(1.22,8.81),P<0.05]。结论肝动脉化疗栓塞联合索拉非尼组较单纯肝动脉化疗栓塞组能够提高患者1年生存率、治疗有效率和疾病控制率,降低VEGF水平,但手足综合征及高血压的发病率较高。Objective To evaluate the curative effect of TACE combined with Sorafinib and TACE treating the advanced hepatocellular carcinoma. Methods Searched CNKI, Wan Fang, Medline, Embase, Cochrane library to find the published literature of TACE combined with Sorafenib to treat the advanced hepatoeellular carcinoma. Observed the 1 year survival rate, treatment effective rate（RR）, disease control effective rate （DCR）, the rate of VEGF change before and after treatment, the in- cidence of adverse events （gastrointestinal symptoms, hand-foot syndrome, hypertension）. The results were incorporated into the TACE combined with Sorafenib group （T＋S group） and TACE group （group T）. The data were analyzed with Reviews 5.2 soft- ware. Results A total of 6 randomized controned articles were included in study （360 cases）, the ratio of male and female was 2.96：1. There were 269 cases in T＋S group, 91 cases in T group. 1 year survival rate had statistical significance [OR=4.06, 95%CI： （ 1.62,10.20）,P〈0.05], the effective rate of treatment had statistical significance [OR=2.11,95%CI： （ 1.30,3.44）,P〈0.05], disease control rate had statistical significantce [OR=4.52,95%CI： （2.69,7.58）,P〈0.05], the rate of VEGF changes before treat- ment had no statistical significance [WMD=0.00,95%CI： （-0.37,0.37）, P=1.00], the VEGF change after rate of treatment had statistical significance [WMD=-1.23,95%CI： （-1.64,-0.82）, P〈0.05], the VEGF changes rate of T＋S group before and after treatment had statistical significance [WMD=0.96,95%CI： （0.56,1.36）, P〈0.05], the VEGF changes rate of T group before and after treatment had no statistical significance [WMD=-0.23,95%CI： （-0.61,0.14）, P〉0.05], the incidence of gastrointestinalsymptoms had no statistical significance [0R=1.57,95%CI： （0.81,3.03）, P〉O.05], the incidence of hand-foot syndrome had statistical significance [0R=14.83,95%CI： （3.84,57.25）, P〈0.05], the incidence of hypertension had statistical signi

关 键 词：肝动脉化疗栓塞 索拉非尼 肝细胞癌 

分 类 号：R735.7[医药卫生—肿瘤]