肝动脉化疗栓塞联合索拉非尼治疗中国人群中晚期肝细胞癌的meta分析  

Transcatheter Arterial Chemoembolization Combined with Sorafenib in Treatment of Intermediate or Advanced Hepatocellular Carcinoma of Chinese: A Meta Analysis

作　　者：高飞[1] 韩斌[1] 庞志刚[1] 陈文超[1] 

机构地区：[1]郑州大学第二附属医院普外科,河南郑州450014

出　　处：《中国普外基础与临床杂志》2015年第8期962-966,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的系统评价肝动脉化疗栓塞（TACE）联合索拉非尼与单一TACE治疗中国人群中晚期肝癌的疗效与安全性。方法检索Pub Med、Embase、Cochrane图书馆、CBM、CNKI、VIP、万方等数据库,查找比较TACE联合索拉非尼与单一TACE治疗中国人群中晚期肝癌的随机对照试验（RCT）,检索时限从建库至2014年12月。对纳入的文献进行资料提取和质量评价,采用Rev Man 5.1软件进行meta分析。结果最终纳入6项研究共498例患者。meta分析结果显示,在中国人群中,相比单一TACE治疗,TACE联合索拉非尼治疗能提高中晚期肝癌患者的客观有效率（OR=2.28,95%CI为1.52~3.42,P〈0.000 1）及疾病控制率（OR=6.62,95%CI为4.12~10.65,P〈0.000 01）,差异有统计学意义,能有效提高患者的1年生存率（OR=3.27,95%CI为2.06~5.22,P〈0.000 01）及2年生存率（OR=4.55,95%CI为2.28~9.07,P〈0.000 1）,同时对不良反应具有良好的耐受性及安全性。结论在中国人群中,对于不可手术切除的中晚期肝癌患者,TACE联合索拉非尼治疗,相比单一TACE治疗可以有效提高客观有效率、疾病控制率,提高患者1年及2年生存率,但是由于纳入文献的评价质量不高等因素的限制,应谨慎对待本研究结论。Objective To systematically review the efficacy and safety of transcatheter arterial chemoembolization（TACE） combined with sorafenib and TACE only treating the intermediate or advanced hepatocellular carcinoma（HCC） in Chinese people. Methods The Pub Med, Embase, Cochrane Library, CBM, CNKI, VIP, and Wanfang Data for randomized controlled trials（RCT） on TACE combined with sorafenib（TACE combined with sorafenib group） and TACE（TACE alone group） from inception to December 2014 were searched. The literatures and data were screened and extracted. The meta analysis was performed using Rev Man 5.1 software. Results Six RCTs involving 498 patients with HCC were included. The results of meta analysis showed that the objective response rate [OR=2.28, 95% CI（1.52-3.42）,P0.000 1] and the disease control rate [OR=6.62, 95% CI（4.12-10.65）, P0.000 01] were higher, the 1-year survival rate [OR=3.27, 95% CI（2.06-5.22）, P0.000 01] and 2-year survival rate [OR=4.55, 95% CI（2.28-9.07）, P0.000 1] were longer, the safety and tolerability of adverse reactions were better in the TACE combined with sorafenib group as compared with the TACE alone group. Conclusions In Chinese people, compared with TACE alone group, TACE combined with sorafenib group have higher objective response rate, disease control rate, 1-year survival rate, and 2-year survival rate. However, due to the lower quality of included literatures, these conclusions should be treated cautiously.

关 键 词：肝动脉化疗栓塞 索拉非尼 肝细胞癌 META分析 

分 类 号：R735.7[医药卫生—肿瘤]