摘要
目的：分析比较经动脉化疗栓塞（transarterialchemoembolization，TACE）联合射频消融（radiofrequencyabla—tion，RFA）和单独应用TACE或RFA治疗原发性肝癌的临床疗效。方法：利用计算机检索PubMed、Medline、Embase、中国期刊全文数据库（CNKI）及万方数据库收录的关于比较TACE联合RFA与单独TACE和（或）RFA治疗原发性肝癌临床疗效及预后的随机对照试验。应用ReviewManager（Version4．2．2．）软件，按照Cochrane协作网推荐的方法，对符合纳入标准的文献报道结果进行Meta分析。结果：本研究纳入6组随机对照试验，共包括原发性肝癌患者376例。根据异质性检验结果，总体生存率：I21年=0，χ21年＝0．81，P1年＝0．94；I23年＝35．5％，χ23年＝6．20，P3年＝0．18；肿瘤无复发生存率：I21年＝10．06％，χ21年＝2．24，P1年＝0．33；I23年=0，χ23年＝1．03，P3年＝0．60，应用固定效应模型进行合并分析。Meta分析结果显示，TACE序贯联合RFA治疗原发性肝癌的1年总体生存率优于单独TACE或RFA治疗，0R1年＝4．61，95％CI为2．26～9．42，P〈0．001，3年总体生存率优于单独TACE或RFA治疗，OR3年＝2．79，95％CI为1．69～4．61，P〈0．001，3年肿瘤无复发生存率优于单独TACE或RFA治疗，OR3年＝3．00，95％CI：1.75～5．13，P〈0．001；1年肿瘤无复发生存率方面，联合介入治疗与单一介入治疗差异无统计学意义，OR1年=1．55，95％CI为0．91～2．65，P=0．11。结论：TACE联合RFA治疗原发性肝癌患者显著优越于TACE和RFA单独疗法。
OBJECTIVE： To comprehensively compare the effectiveness of the combination of TACE and PRFA with that of TACE and RFA alone for hepatoeellular carcinoma （HCC）. METHODS： PubMed, Medline,Embase,China Nation- al Knowledge Internet （CNKI） and Wan fang database were used for searching literatures on comparison of the effective- ness of the combination of TACE and PRFA with that of TACE and/or RFA alone for treatment of HCC. Review Manag- er （Version 4.2.2. ） software from Cochrane Collaboration was used for this meta-analysis. According to the results of the test for heterogeneity,either the fixed-effects model or random effects model was used to pool the results of the included sixteen studies. RESULTS： Six randomized controlled trials were included in this meta-analysis and totally 376 HCC pa- tients were included. Based on the results of the test for heterogeneity（overall survival rates： I21year= 0, χ21year = 0. 81, P1 year = 0.94 ; I23year= 35. 5 %, χ23 year = 6. 20, P3 year = 0. 18 ; recurrence-free survival rates ： I21 year = 10. 06 %, χ21 year = 2. 24, P1 year =0. 33; I23yaer= 0, χ23 year= 1. 03, P3 year= 0. 60）, the fixed-effects model was used for this study. The results of the meta-analysis showed that the 1- and 3-year overall survival rate（OR1 yoar =4. 61,95% CI 2.26- 9.42 ,P〈0. 001 ;OR3 year= 2.79,95%CI 1.69-4.61 ,P〈0. 001） and 3-year recurrence-free survival rate（OR3yaer=3.00,95%CI 1.75-5.13,P〈0. 001） of the combination of TACE and RFA were much better than that of TACE and RFA alone for treatment of HCC. However,there was no significant differences on 1-year recurrence-free survival rate （OR1 year =1. 55,95 % CI 0. 91 - 2. 65, P = 0.11）. CONCLIJSION： The combination of TACE and RICA has advantages in improving overall survival rates, and pro- vides better prognosis than that of TACE and RFA monotherapy for patients with HCC.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2013年第18期1441-1445,共5页
Chinese Journal of Cancer Prevention and Treatment
基金
广东省自然科学基金(10151008901000182)
关键词
肝肿瘤
经动脉化疗栓塞
射频消融
META分析
liver neoplasmstransarterial chemoembolization
radiofrequency ablation
meta-analysis
