TACE联合索拉非尼治疗晚期肝癌的Meta分析  

TACE combined with Sorafenib in the treatment of advanced HCC:a Meta-analysis

作　　者：张明娟[1] 刘佳[1] 向晓星[1] 邓登豪[1] 王甦[1] 

机构地区：[1]扬州大学医学院附属苏北人民医院消化内科,江苏扬州225001

出　　处：《中华肿瘤防治杂志》2015年第2期148-154,160,共8页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的评价肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)联合靶向多激酶抑制剂索拉非尼治疗晚期肝癌的疗效。方法使用计算机检索1989-01-2013-07公开发表在PubMed数据库、Springer Link、Elsevier Sciencedirect、Cochrane、中文科技期刊全文数据库、万方数据库和中国学术期刊数据库,有关TACE联合索拉非尼治疗晚期肝癌的研究,并使用Cochrane协作网提供的RevMan 5.0对所纳入的研究进行Meta分析,发表偏倚用漏斗图评估。结果最终有12项研究纳入分析,TACE联合索拉非尼治疗晚期肝癌的客观有效率(objective response rate,ORR)及疾病控制率(disease control rate,DCR)分别为26.23%和74.86%,均优于单独使用TACE的13.67%和53.48%,P<0.05;TACE联合索拉非尼治疗晚期肝癌的半年及1年生存率分别为94.81%和66.13%,与单独使用TACE的82.98%和41.53%相比,联合索拉非尼可以提高晚期肝癌的半年及1年生存率,P<0.05。联合索拉非尼治疗组的不良反应高于单独使用TACE组,不良反应以手足综合征、乏力和腹泻等较为常见,予对症处理后好转,无其他严重不良反应。结论TACE联合索拉非尼治疗晚期肝癌有效且安全。OBJECTIVE To assess the effectiveness of transcatheter arterial ehemoembolization （TACE） combined sorafenib in the treatment of advanced hepatocellular carcinoma （HCC）. METHODS Clinical data of advanced HCC trea ted by TACE and isorafenib were collected from computer literature searching, tracing January 1989 to July 2013, with car- ried out in PubMed, Springer Link, Elsevier Sciencedirect, Cochrane, China Science and Technology Journal Database （CSTJ）, Wanfang and China Academic Journal Network Publishing Database （CAJD）. RevMan5.0 software, which was recommended by the Cochrane Collaboration,was used for meta analysis. Publication bias was assessed by using a funnel plot. RESULTS There were 12 studies included in the final analysis. The objective response rate and disease control rate of TACE combined sorafenib treatment of advanced hepatocellular carcinoma respectively was 26. 23% and 74. 86%, which were superior to TACE alone 13.67% and 53.48%, P〈0. 05. The six-month and one-year survival rates of TACE combined with sorafenib treatment of advanced hepatocellular carcinoma were 94.81 % and 66.13 %, comparing with TA- CE alone（82.98% and 41.53%）, combination with sorafenib can improve six-month and one-year survival rates of ad- vanced hepatoeellular carcinoma survival rates, P〈0. 05. The adverse events of TACE combined with sorafenib treatment of advanced hepa＇tocellular carcinoma were higher than that of TACE alone, and the most common adverse events were hand-foot syndrome, fatigue and diarrhea. The side effects were tolerable. CONCLUSION TACE combined sorafenib is effective and safe for the treatment of advanced hepatocellular carcinoma.

关 键 词：晚期肝癌 肝动脉化疗栓塞术 索拉非尼 多吉美 META分析 

分 类 号：R735.7[医药卫生—肿瘤]