恩度联合TACE治疗对原发性肝癌患者的有效性及安全性的Meta分析  

Efficacy and Safety of Endostatin Combined with TACE for Hepatocellular Carcinoma: A Meta-analysis

作　　者：谢华英[1] 陈海燕[1] 徐欣[1] 胡斌[1] 黄仁华[1] 叶明[1] 

机构地区：[1]上海交通大学医学院附属仁济医院,200127

出　　处：《实用癌症杂志》2016年第9期1507-1511,共5页The Practical Journal of Cancer

摘　　要：目的 评估恩度联合经肝动脉化疗栓塞术（TACE）治疗原发性肝癌的有效性及安全性。方法 检索PubMed、美国临床肿瘤学会年度会议及欧洲癌症大会的在线论文、万方数据库、中国科技期刊数据库、CNKI数据库中发表的随机对照试验和相关评论文章的参考文献列表。检索关键词包括：“原发性肝癌”,“恩度”或“重组人血管内皮抑素”。结果 TACE联合恩度治疗提高了患者的1年总体生存率（OS）[相对危险度（RRs）=0.75,95%可信区间（CI）：0.61-0.93,P=0.009]、2年OS（RRs=0.52,95%CI：0.29-0.93,P=0.03）、1年无进展生存期（PFS）（RRs=0.59,95%CI：0.45-0.78,P=0.0002）,未提高患者的半年OS。联合恩度治疗组提高患者的客观缓解率与疾病控制率,并降低甲胎蛋白阳性患者比例。联合恩度治疗组的白细胞、血红蛋白、血小板的下降,谷丙转氨酶、血肌酐的升高及心电图ST-T改变均未见加重。在影像学上,联合恩度治疗组未减低患者的血流量、血容量、血管表面渗透面积。联合恩度治疗组减少患者的微血管密度,并在术后第7、14、21、30、35天减少了血清血管内皮生长因子的表达。结论 TACE联合恩度治疗原发性肝癌,安全有效。Objective To evaluate the efficacy and safety of endostatin combined with TACE for hepatocellular carcino- ma. Methods Randomized clinical trials on endostatin-based therapy were identified by electronic searches using a combination of ＂hepatocellular carcinoma＂ ,＂ transcatheter arterial chemolization, TACE＂ ,＂ Endostatin＂ or ＂Recombinant human endostatin＂. Results Endostatin combined with TACE improved 1-year overall survival rate（ RRs =0.75,95% CI：0.61 to 0.93 ,P =0.009） and 2- year overall survival rate（ RRs = 0.52,95% C1：0.29 to 0.93, P = O. 03 ）, and 1 -year progression-free survival rate （ RRs =0.59,95% C1：0.45 to 0.78, P = 0. 0002）. And endostatin also improved the ratio of patients with negative AFP. The side effects of Endostatin therapy were equal between the 2 groups. The blood flow, blood volume and permeability surface of endostatin therapy were not reduced. The analysis showed the microvessel density significantly decreased in endostatin group. Meanwhile, the expression of vascular endothelial growth factor significantly decreased on the 7 day, 14 day,21 day,30 day and 35 day. Conclu- sion Endostatin combined with TACE for hepatocellular carcinoma is safe and effective.

关 键 词：恩度 原发性肝癌 荟萃分析 经肝动脉化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]