经动脉放疗栓塞术治疗不可切除肝内胆管细胞癌疗效与安全性Meta分析  

Efficacy and safety of transarterial radioembolization for unresectable intrahepatic cholangiocarcinoma:a Meta-analysis

作　　者：吴添庆 王炯亮 郑梽楷 李文轩 周仲国[1] Wu Tianqing;Wang Jiongliang;Zheng Zhikai;Li Wenxuan;Zhou Zhongguo(Department of Hepatobiliary Surgery,Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,Guangzhou 510060,China)

机构地区：[1]中山大学肿瘤防治中心肝脏外科、华南肿瘤学国家重点实验室、肿瘤医学协同创新中心,广州510060

出　　处：《中华肝脏外科手术学电子杂志》2023年第2期190-195,共6页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：基金资助:吴阶平医学基金会临床科研专项资助基金(320.6705.2021-02-76);中山大学肿瘤防治中心临床医学科学家基金(16zxqk04)。

摘　　要：目的探讨经动脉放疗栓塞术(TARE)治疗不可切除肝内胆管细胞癌(ICC)的疗效与安全性。方法检索PubMed、Embase、Cochrane Library数据库中TARE治疗不可切除ICC的所有英文文献。采用主题词联合自由词进行文献检索,检索词为cholangiocarcinoma、cholangiocellular carcinoma、unresectable、advanced、TARE、transarterial radioembolization等。检索时间从建库至2022年4月1日。主要指标为客观缓解率(ORR);次要指标为1、2、3年生存率,不良反应发生率。采用Stata 12.0对文献进行Meta分析。结果共纳入18篇文献739例患者进行Meta分析。Meta分析显示,TARE治疗不可切除ICC的ORR为20.5%。其中钇90树脂微球组ORR为22.9%,钇90玻璃微球组为20.5%,差异无统计学意义(χ2=0.10,P=0.75)。体力状况较好组ORR为22.3%,体力状况较差组为12.4%,差异亦无统计学意义(χ2=2.05,P=0.15)。TARE治疗患者1、2、3年生存率分别为39.8%、17.9%、5.5%。TARE治疗后最常见的不良反应为乏力,发生率39%;严重不良反应主要为肝衰竭和消化性溃疡,发生率3.2%和2.9%。结论在不可切除ICC患者中,TARE的疗效尚可,严重不良反应发生率低。Objective To evaluate the efficacy and safety of transarterial radioembolization(TARE)in the treatment of unresectable intrahepatic cholangiocarcinoma(ICC).Methods All literature in English related to TARE in the treatment of unresectable ICC were searched from PubMed,Embase and Cochrane Library databases.Literature search was carried out using subject words and free words,and the searching words were cholangiocarcinoma,cholangiocellular carcinoma,unresectable,advanced,TARE and transarterial radioembolization,etc.The retrieval time was from the database inception date to April 1,2022.The main index was objective remission rate(ORR)and the secondary indexes were the 1-,2-and 3-year survival rate and incidence of adverse reactions.Meta-analysis was performed by Stata 12.0 software.Results A total of 739 patients from 18 studies were included for Meta-analysis.Meta-analysis revealed that the ORR of TARE for unresectable ICC was 20.5%.The ORR in the Yttrium-90 resin microsphere group was 22.9%,and was 20.5%in the Yttrium-90 glass microsphere group,where no significant difference was observed(χ2=0.10,P=0.75).In the good physical condition group,the ORR was calculated as 22.3%and 12.4%in the poor physical condition group,and no significant difference was observed(χ2=2.05,P=0.15).The 1-,2-and 3-year survival rates of patients treated with TARE were 39.8%,17.9%and 5.5%,respectively.Fatigue was the most common adverse reaction after TARE with an incidence of 39%.The major severe adverse reactions consisted of liver failure(3.2%)and peptic ulcer(2.9%).Conclusions TARE yields acceptable clinical efficacy and low incidence of severe adverse reactions in patients with unresectable ICC.

关 键 词：经动脉放疗栓塞术 肝内胆管细胞癌 META分析 

分 类 号：R735.7[医药卫生—肿瘤]