CAJ | 학술논문

目的：系统评价含奥沙利铂（ OXA）的系统化疗方案治疗晚期原发性肝癌，主要是肝细胞癌（ HCC）的有效性和安全性的前瞻性研究。方法检索PubMed、Cochrane Library、EMBASE、Web of Science、中国期刊全文数据库、中国生物医学文献数据库以及万方数据库等文献数据库，检索时限均为建库至2015年4月。收集含OXA系统化疗方案治疗HCC的研究文献，进行文献质量评价后，采用Stata12?0软件对满足纳入标准的研究进行Meta分析。结果共纳入符合标准的文献12篇，合计600例患者。 Meta分析结果显示，含OXA系统化疗方案对于晚期HCC患者具有一定的客观疗效，缓解率（ RR）为14?0％（95％CI：9?5％～18?5％），12项研究中患者的中位无进展生存期（PFS）和中位总生存期（OS）分别为4?7个月和9?5个月，1年无进展生存率和1年生存率分别为19?0％和35?6％。中、重度（3、4级）不良反应主要为中性粒细胞减少（16?6％）、血小板减少（8?7％）、贫血（5?4％）、神经毒性（4?9％）、恶心呕吐（1?8％）以及腹泻（2?9％）。进一步亚组分析表明，亚洲和西方患者的RR分别为13?9％（95％CI：8?1％～19?7％）和14?2％（95％CI：5?3％～23?1％）；亚洲患者群的中位PFS和中位OS分别为3?0个月和9?4个月，1年无进展生存率和1年生存率分别为12?9％和30?3％；而西方患者群依次为4?7个月、9?5个月、20?0％和42?4％。亚洲和西方患者群对含OXA系统化疗方案治疗晚期HCC的RR、1年无进展生存率和1年生存率之间均无显著差异（ P＞0?05）。结论采用含OXA系统化疗方案治疗晚期HCC行之有效，安全性较好，不良反应可以耐受，建议作为临床上合理、可行的治疗选择。
목적：계통평개함오사리박（ OXA）적계통화료방안치료만기원발성간암，주요시간세포암（ HCC）적유효성화안전성적전첨성연구。방법검색PubMed、Cochrane Library、EMBASE、Web of Science、중국기간전문수거고、중국생물의학문헌수거고이급만방수거고등문헌수거고，검색시한균위건고지2015년4월。수집함OXA계통화료방안치료HCC적연구문헌，진행문헌질량평개후，채용Stata12?0연건대만족납입표준적연구진행Meta분석。결과공납입부합표준적문헌12편，합계600례환자。 Meta분석결과현시，함OXA계통화료방안대우만기HCC환자구유일정적객관료효，완해솔（ RR）위14?0％（95％CI：9?5％～18?5％），12항연구중환자적중위무진전생존기（PFS）화중위총생존기（OS）분별위4?7개월화9?5개월，1년무진전생존솔화1년생존솔분별위19?0％화35?6％。중、중도（3、4급）불량반응주요위중성립세포감소（16?6％）、혈소판감소（8?7％）、빈혈（5?4％）、신경독성（4?9％）、악심구토（1?8％）이급복사（2?9％）。진일보아조분석표명，아주화서방환자적RR분별위13?9％（95％CI：8?1％～19?7％）화14?2％（95％CI：5?3％～23?1％）；아주환자군적중위PFS화중위OS분별위3?0개월화9?4개월，1년무진전생존솔화1년생존솔분별위12?9％화30?3％；이서방환자군의차위4?7개월、9?5개월、20?0％화42?4％。아주화서방환자군대함OXA계통화료방안치료만기HCC적RR、1년무진전생존솔화1년생존솔지간균무현저차이（ P＞0?05）。결론채용함OXA계통화료방안치료만기HCC행지유효，안전성교호，불량반응가이내수，건의작위림상상합리、가행적치료선택。
Objective To systemically evaluate the efficacy and safety of oxaliplatin ( OXA)?based systemic chemotherapy regimens for advanced primary hepatic carcinoma, mainly hepatocellular carcinoma ( HCC ) . Methods The original articles were searched from PubMed, the Cochrane Library, EMBASE, Web of Science, CNKI, CBM and CECDB from inception to April 2015. Then we recruited the articles about OXA?based chemotherapy regimens for HCC, and evaluated the quality of literature. Finally we carried out a meta analysis of the eligible articles using Stata12?0. Results Twelve study reports, including 600 patients were recrui?ted in this study. The results of meta analysis showed that OXA?based chemotherapy regimens had certain curative effect on advanced HCC patients. The overall response rate ( RR) was 14?0 %( 95%CI: 9?5%?18?5%) . The median progression free survival ( PFS)/median overall survival ( OS) was 4?7/9?5 months, with 1 year progression free survival rate/1 year survival rate were 19?0%/35?6%. The common moderate?severe ( grade 3/4) toxicities were neutropenia ( 16?6%) , thrombocytopenia ( 8?7%) , anemia ( 5?4%) , neu?rotoxicity(4?9%), nausea/vomiting (1?8%) and diarrhea (2?9%). In the subgroup analysis, RR of Asian and Western patients were 13?9% (95%CI:8?1%?19?7%) and 14?2%(95%CI:5?3%?23?1%)respectively. In Asian studies, the median PFS/median OS and 1 year progression free survival rate/1 year survival rate were 3?0/9?4 months and 12?9%/30?3% respectively. In Western studies, median PFS/OS and 1 year progression free survival rate/1 year survival rate were 4?7 months/9?5 months and 20?0%/42?4% respec?tively. RR, 1 year progression free survival rate and 1 year survival rate of OXA?based systemic chemotherapy regimens for advanced HCC had no significant difference ( P>0?05) between Asian and Western patients. Conclusion OXA?based systemic chemotherapy regimens are effective and safe for advanced HCC. It indicates that OXA?based systemic chemotherapy is a good and viable option for patients with advanced HCC.