摘要
目的:系统评价肝动脉化疗栓塞术(TACE)联合细胞因子诱导的杀伤细胞(CIK)治疗原发性肝癌(HCC)患者的疗效及安全性,为临床应用与深入研究提供参考。方法:计算机检索Cochrane Library、PubM ed、万方和中国期刊全文数据库、VIP等数据库。收集所有比较肝动脉化疗栓塞术联合细胞因子诱导的杀伤细胞与单纯肝动脉化疗栓塞术治疗原发性肝癌的随机对照试验(RCT)。采用Cochrane协作网RevM an5.2软件进行Meta分析。结果:纳入9个文献,共784例患者。Meta分析结果显示,TACE联合CIK治疗组与单纯TACE治疗组相比,两组的0.5、1、2年生存率、卡氏评分(Karnofsky)提高率、反应率(RR)、CD3+细胞百分比、CD4+细胞百分比差异均有统计学意义,其RR或SMD(95%CI)分别为[RR=1.31,95%CI(1.18,1.47)]、[RR=1.71,95%CI(1.40,2.08)]、[RR=3.24,95%CI(1.97,5.31)]、[RR=1.76,95%CI(1.26,2.45)]、[RR=1.90,95%CI(1.14,3.14)]、[SMD=0.98,95%CI(0.73,1.23)]、[SMD=0.87,95%CI(0.40,1.34)]。而两个治疗组在CD8+细胞的百分比上差异无统计学意义[SMD=-0.02,95%CI(-0.39,0.34)]。结论:相比单纯TACE术,TACE联合CIK疗法不仅可以显著改善晚期肝癌患者的生存质量、免疫功能及治疗反应率等近期疗效,而且也可以提高患者远期生存率。
Objective：To evaluate the effectiveness and safety of cytokine-induced kill cell combined with TACE therapy in the treatment of advanced hepatocellular carcinma,so as to provide references for clinical practice and study.Methods：Randomized controlled trials（ RCTs） on cytokine-induced killer（ CIK） cells combination with TACE based-therapy were identified by electronic searches in the Cochrane Library,Pub Med,Wan fang,VIP,CNKI and other electronic databases.Meta-analysis was conducted by the Cochrane Collaboration＇s Rev Man 5.2 software.For qualitative data,data mainly adopts descriptive methods.Results：A total of 9 RCTs involving 784 patients were included.The results of meta-analyses showed that： There were significant differences between the TACE combined with the CIK group and the TACE group in 0.5-,1-,2-year survival rate,the quality of life improvement rate（KPS） and response rate（RR = CR ＋ PR）,and the percentage of CD3＋、CD4＋cells.RR or SMD value and 9 5 %CI were [RR = 1.31,95% CI（1.18,1.47）],[RR = 1.71,95% CI（1.40,2.08）],[RR = 3.24,95% CI（1.97,5.31）],[RR = 1.76,95% CI（ 1.2 6,2.4 5） ],[RR = 1.9 0,9 5 % CI（ 1.1 4,3.1 4） ],[SMD = 0.98,95%CI（0.73,1.23）],[SMD = 0.87,95% CI（ 0.40,1.34）],respectively.There was no significant difference in the percentage of CD8＋cells [SMD =-0.02,95% CI（-0.39,0.34）].Conclusion：Compared with TACE alone,TACE ＋ CIK can improve Quality of life,immune function,response to treatment and survival rate.
出处
《现代肿瘤医学》
CAS
2015年第6期828-834,共7页
Journal of Modern Oncology
关键词
原发性肝癌
肝动脉化疗栓塞术
细胞因子诱导的杀伤细胞
系统评价
META分析
随机对照试验
hepatocellular carcinoma
transcatheterarterial chemoembolization
cytokine-induced killer cells
sys-tematic review
Meta-analysis
randomized controlled trias
