肝动脉化疗栓塞联合阿帕替尼治疗中晚期肝癌有效性和安全性Meta分析  

Meta-analysis of the efficacy and safety of TACE combined with apatinib in the treatment of advanced primary liver cancer

作　　者：罗朝霞 夏辉[2] 龚昭[2] 姚磊 LUO Zhaoxia;XIA Hui;GONG Zhao(Department of General Surgery,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430000,China)

机构地区：[1]武汉科技大学附属天佑医院普外科,430000 [2]武汉市第一医院肝胆外科 [3]华润武钢总医院胃肠外科

出　　处：《临床外科杂志》2022年第12期1129-1132,共4页Journal of Clinical Surgery

摘　　要：目的利用Meta分析评价肝动脉化疗栓塞(TACE)联合阿帕替尼治疗原发性进展期肝癌的有效性及安全性。方法检索收集2015年1月1日~2021年7月25日中国知网数据库、万方数据库、中国生物医学文献数据库、维普中文科技期刊数据库、PubMed、Embase、The Cochrane Library、中国临床试验注册中心、ClinicalTrials.gov采用TACE联合阿帕替尼治疗中晚期肝癌的随机对照研究文献,进行Meta分析。结果共纳入20篇文献,均为RCT,共1373例病人,分为两组,联合治疗组687例,采用TACE联合阿帕替尼治疗,非联合组686例,采用TACE治疗。联合组客观缓解率较对照组显著增高(P<0.05)。两组6个月生存率无明显差异(P>0.05),但与非联合组相比较,实验组的1年、2年生存率有明显提高(P<0.05)。不良反应中,两组恶心、呕吐发生率比较差异无统计学意义(P>0.05),但发热、腹痛、骨髓抑制、腹泻、高血压、蛋白尿、手足综合征方面,两组存在明显差异(P<0.05)。结论TACE联合阿帕替尼针对中晚期肝癌的治疗效果显著,但要考虑蛋白尿、高血压、手足综合征等不良反应的预防和治疗。Objective To evaluate the efficacy and safety of TACE combined with apatinib in the treatment of advanced primary progressive hepatic carcinoma by Meta-analysis.Methods The literatures of randomized controlled studies on TACE combined with apatinib in the treatment of advanced liver cancer from January 1,2015 to July 25,2021 were retrieved for Meta-analysis.Results A total of 20 publications were included,all RCTs,with a total of 1373 patients,including the experimental group(n=687)and the control group(n=686).The objective sustained release rate(ORR)of the experimental group was significantly higher than that of the control group(P<0.05).There was no significant difference in the 6-month survival rate between the two groups(P>0.05),but compared with the control group,the 1-year and 2-year survival ratein the experimental group were significantly higher than those in the control group(P<0.05).There was no significant difference in the incidence of nausea and vomiting between the two groups(P>0.05).The symptoms of fever,abdominal pain,myelosuppression,diarrhea,hypertension,proteinuria,and hand-foot syndrome between groups had statistical significance(P<0.05).Conclusion TACE combined with apatinib is more effective in treating of advanced primary hepatic carcinoma,while the prevention and treatment of adverse effects such as proteinuria,hypertension,and hand-foot syndrome should also be considered.

关 键 词：阿帕替尼 肝动脉化疗栓塞 META分析 中晚期肝癌 

分 类 号：R735.7[医药卫生—肿瘤]