摘要
目的评价肝动脉化疗栓塞(TACE)联合放疗治疗中晚期肝癌的疗效及安全性。方法使用计算机检索从2007年1月至2018年7月公开发表在PubMed、Embase、Cochrane、Clinical Trails、中国知网、万方、维普等数据库中TACE联合放疗(联合组)对比单独TACE治疗(单独组)中晚期肝癌的疗效与安全性的临床研究报道,并使用RevMan 5.3对所纳入的研究进行荟萃分析,Egger法分析发表偏倚。结果最终纳入21篇随机对照试验(RCT),共1 574例中晚期肝癌。联合组的客观缓解率(ORR)为77.1%,优于单独组的52.5%,P<0.05;联合组治疗中晚期肝癌的1、2和3年生存率分别为74.6%、50.5%、33.6%,明显高于单独组的52.8%、27.7%和16.4%(P均<0.05)。不良反应以白细胞降低、肝功能受损、发热、消化道反应多见,予以对症处理后好转,无其他严重不良反应。结论 TACE联合放疗治疗中晚期肝癌在近期疗效、生存率及安全性上优于单独TACE治疗,且不良反应可耐受。
Objective To evaluate the clinical efficacy and safety of transcatheter arterial chemoembolization(TACE) combined with radiotherapy in treating mid-stage and advanced liver cancers.Methods Computer-assisted retrieval of the clinical research reports concerning the efficacy and safety of combination use of TACE and radiotherapy for mid-stage and advanced liver cancers, that were published from January 2007 to July 2018, from PubMed, Embase, Cochrane, Clinical Trails, China Knowledge Network, Wanfang, VIP and other databases was conducted. RevMan 5.3 was used to make meta-analysis of the included materials, and Egger method was used to analyze publication bias. Results A total of 21 randomized controlled trial(RCT) articles(1574 mid-stage and advanced liver cancer cases in total) were enrolled in this study. The objective effective rate(ORR) in TACE combined with radiotherapy group(combination group) was 77.06%, which was obviously better than 52.48% in simple TACE group(P<0.05).The one-, 2-and 3-year survival rates in combination group were 74.63%, 50.54% and 33.55%respectively, which were significantly higher than those of 52.76%, 27.66% and 16.38% respectively in simple TACE group(P<0.05). The common adverse reactions were leukopenia, impaired liver function, fever and digestive tract reaction, which were improved after symptomatic treatment. No other severe adverse reactions occurred. Conclusion In treating mid-stage and advanced liver cancers, TACE combined with radiotherapy is superior to simple TACE therapy in short-term curative effect, survival rate and clinical safety, besides, its adverse reactions can well be tolerated by patients.
作者
周旭林
满沐苒
王璐璐
周晓明
刘清华
ZHOU Xulin;MAN Muran;WANG Lulu;ZHOU Xiaoming;LIU Qinghua(Department of Oncology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, the Xinjiang Uygur Autonomous Region 832000, China)
出处
《介入放射学杂志》
CSCD
北大核心
2019年第5期428-435,共8页
Journal of Interventional Radiology
基金
石河子大学医学院第一附属医院创新团队项目(TD201801)
海南省基础与应用基础研究计划(818MS064)
关键词
肝癌
荟萃分析
放疗
肝动脉化疗栓塞
随机对照试验
liver cancer
meta-analysis
radiotherapy
transcatheter arterial chemoembolization
randomized controlled trial
