重组人血管内皮抑制素联合TACE治疗中晚期原发性肝癌近期疗效的荟萃分析  

Meta-analysis of rhES combined with TACE versus TACE alone for hepatocellular carcinoma: short-term therapeutic efficacy and subgroup analysis

作　　者：赖军明 胡爽 林红[3] 罗辉[3] 骆永彪 Lai Junming;Hu Shuang;Lin Hong;Luo Hui;Luo Yongbiao(Radiotherapy Center, Yiwu Central Hospital, Yiwu 322000, China;Department of General Medicine, Yiwu 322000, China;Department of Oncology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China)

机构地区：[1]义乌市中心医院肿瘤放疗中心,浙江义乌322000 [2]义乌市中心医院全科医学科,浙江义乌322000 [3]南昌大学第一附属医院肿瘤科,南昌330006

出　　处：《中华肝胆外科杂志》2019年第5期358-362,共5页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的系统评价重组人血管内皮抑制素(rhES)联合经导管肝动脉化疗栓塞(TACE)治疗中晚期原发性肝癌的近期疗效。方法计算机检索PubMed、Elsevier、Cochrane Library、CBM、CNKI和万方数据数据库,筛选有关rhES联合TACE治疗中晚期原发性肝癌的对照试验,年限为建库至2018年1月,使用RevMan5.3软件进行荟萃分析。结果共检索到文献458篇,最终纳入18篇,共948例患者,其中rhES +TACE组522例,TACE组426例。根据rhES使用方法进一步分为术中栓塞组、肝动脉泵入组、静脉滴注组。荟萃分析显示,rhES+TACE组的客观有效率(ORR)高于单纯TACE组,差异有统计学意义(RR=1.59,95%CI:1.41~1.79,P<0.05)。术中栓塞组、肝动脉泵入组、静脉滴注组rhES+TACE患者ORR均优于单纯TACE患者(术中栓塞组RR=1.63,95%CI:1.36~1.95;肝动脉泵入组RR=1.49,95%CI:1.24~1.79;静脉滴注组RR=1.69,95%CI:1.22~2.34),差异均有统计学意义(P<0.05)。化疗栓塞药物蒽环类和铂类亚组分析也显示,rhES+TACE患者ORR均优于单纯TACE患者。结论 rhES联合TACE治疗中晚期原发性肝癌的近期疗效优于单纯TACE,且亚组分析也得到相同结果。Objective To evaluate the short-term efficacy of recombinant human endostatin (rhES) combined with transcatheter arterial chemoembolization (TACE) versus TACE alone for intermediate and advanced primary hepatic carcinoma. Methods The relevant controlled trials about rhES plus TACE versus TACE alone in the treatment of intermediate and advanced primary hepatic carcinoma were retrieved from the databases of PubMed, Elsevier, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wan Fang Database. The retrieval time limited was from the database construction to January 2018, and the Meta-analysis was performed by using RevMan5.3 software. Results 18 controlled trials were included in this Meta-analysis. There were 948 cases, of which 522 cases in rhES plus TACE group and 426 cases in TACE alone group. According to the usage of rhES, the trials were further divided into intrahepatic arterial embolization group, intrahepatic arterial pump group, and intravenous infusion group. rhES plus TACE had an overall advantage over TACE alone in terms of objective response rate (ORR), and the difference was statistically significant (RR=1.59, 95%CI: 1.41~1.79, P<0.05). And the ORR of rhES plus TACE in intrahepatic arterial embolization group, intrahepatic arterial pump group, intravenous infusion group was better than that of TACE alone (Intrahepatic arterial embolization group RR=1.63, 95%CI: 1.36~1.95;Intrahepatic arterial pump group RR=1.49, 95%CI: 1.24~1.79;Intravenous infusion group RR=1.69, 95%CI: 1.22~2.34), and the difference was statistically significant (P<0.05). The subgroups analysis of anthracycline and platinum also showed that ORR in rhES plus TACE patients was better than that in TACE patients alone. Conclusion The short-term efficacy of rhES plus TACE in the treatment of intermediate and advanced primary hepatic carcinoma was better than that of TACE alone, and the same results were obtained by subgroup analysis.

关 键 词：肝肿瘤 化学栓塞 治疗性 荟萃分析 重组人血管内皮抑制素 

分 类 号：R735.7[医药卫生—肿瘤]