奥曲肽治疗肝细胞癌有效性和安全性的Meta分析  

Efficacy and safety of octreotide in treatment of hepatocellular carcinoma: a meta-analysis

作　　者：张玉怀[1] 罗长江[1] 

机构地区：[1]兰州大学第二医院普外科,兰州730030

出　　处：《临床肝胆病杂志》2015年第6期922-926,共5页Journal of Clinical Hepatology

摘　　要：目的系统评价奥曲肽治疗肝细胞癌的有效性和安全性。方法系统检索Pub Med、Cochrane图书馆、EMBASE、中国期刊全文数据库（CNKI）、万方数据库和中文科技期刊数据库（VIP）中关于奥曲肽治疗肝细胞癌的随机对照试验（RCT）。采用Cochrane系统评价手册推荐的方法评价纳入研究质量,数据分析采用Rev Man 5.3.4软件。结果纳入11项RCT,共909例患者,其中试验组452例,对照组457例。在临床疗效方面,奥曲肽显著提高了临床有效率[RR=2.30,95%可信区间（95%CI）：1.25～4.22,P=0.007]和降低了疾病进展率（RR=0.78,95%CI：0.59-1.04,P=0.09）,而疾病控制率两组间差异无统计学意义（P〉0.05）;在生存率方面,两组患者总生存率、6个月、1年和2年生存率差异均无统计学意义（P值均〉0.05）;在安全性方面,试验组的严重并发症显著减少（RR=0.72,95%CI：0.54～0.98,P=0.03）,而在腹泻、恶心/呕吐、肝功能异常和血糖波动方面差异无统计学意义（P值均〉0.05）。结论奥曲肽治疗肝细胞癌时可以提高临床有效率,同时减少3/4级严重并发症的发生率,然而在控制疾病进展和提高患者的生存率方面无显著效果。Objective To systematically evaluate the efficacy and safety of octreotide in the treatment of hepatocellular carcinoma（ HCC）.Methods Online databases including Pub Med,Cochrane Library,Embase,China National Knowledge Internet,Wanfang Data,and China Science and Technology Journal Database were comprehensively searched for relevant randomized controlled trials（ RCTs） of octreotide in the treatment of HCC. The quality of included studies was assessed using the method recommended by the Cochrane handbook for systematic review. A meta- analysis was performed by using Rev Man 5. 3. 4 software. Results Eleven RCTs were included,which involved 909 cases（ treatment group,452 cases; control group,457 cases）. As for clinical efficacy,octreotide significantly increased the response rate（ RR =2. 30,95% CI： 1. 25 ～4. 22,P = 0. 007） and decreased the progression rate（ RR = 0. 78,95% CI： 0. 59 ～1. 04,P = 0. 09）,but there was no significant difference in disease control rate and progression rate between the two groups（ P〈0. 05）. The overall survival rate and6- month,1- year,and 2- year survival rates in the treatment group were not significantly higher than those of the control group（ all P〈0. 05）. As regards to safety,severe adverse events in the treatment group were significantly reduced（ RR = 0. 72,95% CI： 0. 54 ～0. 98,P= 0. 03）,but there were no significant differences in diarrhea,nausea / vomiting,liver function abnormality,and blood glucose fluctuation between the two groups（ all P〈0. 05）. Conclusion For HCC patients,octreotide can significantly increase the clinical response rate incidence of grade 3 /4 adverse events,but it does not lead to significant improvement in disease progression and survival rate.

关 键 词：癌 肝细胞 奥曲肽 META分析 

分 类 号：R735.7[医药卫生—肿瘤]