实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
JOURNAL OF CLINICAL HEPATOLOGY
2013年
4期
344-347
,共4页
肝细胞癌%肝动脉栓塞化疗%无水乙醇注射%Meta分析%疗效
肝細胞癌%肝動脈栓塞化療%無水乙醇註射%Meta分析%療效
간세포암%간동맥전새화료%무수을순주사%Meta분석%료효
Hepatocellular carcinoma%Transcatheter arterial chemoembolization%Percutaneous ethanol injec-tion%Meta-analysis%Therapeutic efficacy
目的评价肝动脉栓塞化疗（TACE）联合无水乙醇注射治疗肝细胞癌的疗效和安全性。方法检索PubMed、Cochrane图书馆、Embase、中国生物医学数据库和万方数据库至2012年12月的最新数据，收集所有TACE联合无水乙醇注射与单纯TACE治疗肝细胞癌患者的随机对照研究（RCT）。按照纳入和排除标准选择文献、提取资料和评价纳入研究的方法学质量后，采用RevMan 5.1进行Meta分析。结果在13个RCT共962例患者，显示TACE联合无水乙醇注射治疗1年、2年和3年生存率均较单纯TACE更优，其OR值分别为3.78（95%CI为2.79~5.12）、3.07（95%CI为2.27~4.17）和5.84（95%CI为2.86~11.93）；在其中6个RCT共294例患者，联合治疗患者血清甲胎蛋白下降至正常者显著优于单纯TACE治疗组（OR=4.0，95%CI为2.24~7.15），但两组间AFP下降（≥25%）而未达正常者无明显差异（OR=1.24，95%CI为0.68~2.27）；两组均未出现严重的不良反应。结论 TACE联合无水乙醇注射治疗患者生存率及AFP下降至正常均优于单纯TACE治疗，患者的生存率明显提高，无严重的不良反应。
目的評價肝動脈栓塞化療（TACE）聯閤無水乙醇註射治療肝細胞癌的療效和安全性。方法檢索PubMed、Cochrane圖書館、Embase、中國生物醫學數據庫和萬方數據庫至2012年12月的最新數據，收集所有TACE聯閤無水乙醇註射與單純TACE治療肝細胞癌患者的隨機對照研究（RCT）。按照納入和排除標準選擇文獻、提取資料和評價納入研究的方法學質量後，採用RevMan 5.1進行Meta分析。結果在13箇RCT共962例患者，顯示TACE聯閤無水乙醇註射治療1年、2年和3年生存率均較單純TACE更優，其OR值分彆為3.78（95%CI為2.79~5.12）、3.07（95%CI為2.27~4.17）和5.84（95%CI為2.86~11.93）；在其中6箇RCT共294例患者，聯閤治療患者血清甲胎蛋白下降至正常者顯著優于單純TACE治療組（OR=4.0，95%CI為2.24~7.15），但兩組間AFP下降（≥25%）而未達正常者無明顯差異（OR=1.24，95%CI為0.68~2.27）；兩組均未齣現嚴重的不良反應。結論 TACE聯閤無水乙醇註射治療患者生存率及AFP下降至正常均優于單純TACE治療，患者的生存率明顯提高，無嚴重的不良反應。
목적평개간동맥전새화료（TACE）연합무수을순주사치료간세포암적료효화안전성。방법검색PubMed、Cochrane도서관、Embase、중국생물의학수거고화만방수거고지2012년12월적최신수거，수집소유TACE연합무수을순주사여단순TACE치료간세포암환자적수궤대조연구（RCT）。안조납입화배제표준선택문헌、제취자료화평개납입연구적방법학질량후，채용RevMan 5.1진행Meta분석。결과재13개RCT공962례환자，현시TACE연합무수을순주사치료1년、2년화3년생존솔균교단순TACE경우，기OR치분별위3.78（95%CI위2.79~5.12）、3.07（95%CI위2.27~4.17）화5.84（95%CI위2.86~11.93）；재기중6개RCT공294례환자，연합치료환자혈청갑태단백하강지정상자현저우우단순TACE치료조（OR=4.0，95%CI위2.24~7.15），단량조간AFP하강（≥25%）이미체정상자무명현차이（OR=1.24，95%CI위0.68~2.27）；량조균미출현엄중적불량반응。결론 TACE연합무수을순주사치료환자생존솔급AFP하강지정상균우우단순TACE치료，환자적생존솔명현제고，무엄중적불량반응。
Objective To assess the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with percutaneous ethanol injection (PEI) versus TACE alone in the treatment of patients with hepato-cellular carcinoma (HCC). Methods A systematic search of literatures in PubMed,the Cochrane Library,Em-base, Chinese Biomedicine Literature Database,Wan Fang Database since database establishment to December, 2012 was performed;All randomized controlled trials (RCTs) on TACE combined with PEI versus TACE alone were collected;The literatures were screened according to inclusive and exclusive criteria,and data were extracted and the quality of included studies were assessed;A Meta-analysis was conducted by using RevMan 5.1. Results A total of 13 RCTs with 962 patients was included and the results showed that the 1-,2- and 3-year survival rates of TACE combined with PEI were better than that of TACE alone,with the OR-value of 3.78 (95%CI=2.79 to 5.12),3.07 (95%CI=2.27 to 4.17) and 5.84 (95%CI=2.86 to 11.93),respectively;A total of 6 RCTs with 294 patients out of 14 papers showed that the combination therapy was better than TACE alone (OR=4.0,95%CI=2.24 to 7.15)in the rate of AFP normalization,but the reduction of≥25%(not to normal) in AFP was not significant (OR=1.24,95%CI=0.68 to 2.27);Both Combination therapy and TACE alone did not show serious adverse reac-tions. Conclusion The survival and AFP normalization rate in TACE combine with PEI is better than TACE alone, and there is no increased serious adverse reaction following the improved survival rate.
