PDF下载 ( 2638 KB)
Efficacy and safety of Kanglaite injection combined with transarterial chemoembolization in treatment of advanced liver cancer: A Meta-analysis
-
摘要:
目的对康莱特注射液(KLT)联合经肝动脉化疗栓塞术(TACE)治疗中晚期肝癌的有效性和安全性进行Meta分析。方法检索中国知网、万方数据库、维普数据库、中国生物医学数据库、PubMed、Cochrane Library、Embase自数据库建立至2019年10月的文献,筛选有关KLT与TACE治疗中晚期肝癌的临床研究,试验组为KLT联合TACE治疗,对照组为单独应用TACE治疗。对纳入的文献提取资料及质量评价,采用Revman5. 3软件进行Meta分析。各研究间的异质性采用χ2检验判断;用比值比(OR)和95%可信区间(95%CI)评价结局指标;采用漏斗图对发表偏倚进行评估。结果纳入16篇符合标准的文献,共1131例患者,其中试验组558例,对照组573例。与对照组相比,试验组可显著提高瘤体治疗有效率(OR=2. 85,95%CI:2. 17～3. 76,P <0. 001),提升疾病控制率(OR=2. 58,95%CI:1. 57～4. 24,P <0. 001),提高生存质量卡氏评分(OR=3. 54,95%CI:2. 48～5. 06,P <0. 001),显...
-
关键词:
- 肝肿瘤 /
- 化学栓塞,治疗性 /
- 康莱特注射液 /
- Meta分析(主题)
Abstract:Objective To investigate the efficacy and safety of Kanglaite injection( KLT) combined with transarterial chemoembolization( TACE) in the treatment of advanced liver cancer through a Meta-analysis. Methods CNKI,Wanfang Data,VIP,CBM,PubMed,Cochrane Library,and Embase were searched for clinical studies on KLT combined with TACE in the treatment of advanced liver cancer published up to October 2019. The patients in the experimental group were given KLT combined with TACE,while those in the control group were given TACE alone. Data extraction and quality assessment were performed for the articles included in the analysis,and RevMan 5. 3 was used for Meta-analysis. The chi-square test was used to evaluate heterogeneity between studies; odds ratio( OR) and 95% confidence interval( CI) were used to evaluate outcome measures; funnel plots were used to evaluate publication bias. Results A total of 16 articles which met the inclusion criteria were included,with a total of 1131 patients( 558 patients in the experimental group and 573 in the control group). Compared with the control group,the experimental group had significant increases in tumor response rate( OR = 2. 85,95% CI:2. 17-3. 76,P < 0. 001),disease control rate( OR = 2. 58,95% CI: 1. 57-4. 24,P < 0. 001),and Karnofsky Performance Scale score for quality of life( OR = 3. 54,95% CI: 2. 48-5. 06,P < 0. 001),as well as significant improvements in clinical symptoms( OR = 3. 71,95% CI: 1. 55-8. 89,P = 0. 003) and alpha-fetoprotein level( OR = 2. 57,95% CI: 1. 41-4. 68,P = 0. 002). In addition,the experimental group had a significantly lower incidence rate of bone marrow suppression than the control group( leukocyte reduction: OR = 0. 39,95% CI: 0. 23-0. 66,P < 0. 001; thrombocytopenia: OR = 0. 22,95% CI: 0. 12-0. 42,P < 0. 001). Conclusion In the treatment of advanced liver cancer,KLT combined with TACE results in a high response rate and good quality of life and can reduce the incidence rate of toxic and side effects including bone marrow suppression due to chemotherapy.
-
[1] FORNER A,LLOVET JM,BRUXI J,et al. Hepatocellular carcinoma[J]. Lancet,2012,379(9822):1245-1255. [2] FERLAY J,AHIN HR,BRAYF,et al. Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008[J]. Int J Cancer,2010,127(12):2893-2917. [3] YUAN GQ,MO CJ,ZHANG ZC. Clinical effect of transarterial chemoembolization combined with radiofrequency ablation in treatment of primary liver cancer[J]. Clin J Med Offic,2019,47(10):1126-1127.(in Chinese)袁广庆，莫灿均，张志成．肝动脉化疗栓塞联合射频消融治疗原发性肝癌临床疗效观察[J]．临床军医杂志，2019,47(10):1126-1127. [4] CUI HZ,GE W,CAO DD,et al. Efficacy of Apatinib Mesylate combined with hepatic artery embolization chemotherapy in the treatment of advanced primary liver cancer[J]. China Med Herald,2019,16(14):88-91.(in Chinese)崔海忠，戈伟，曹德东，等．甲磺酸阿帕替尼联合肝动脉栓塞化疗治疗中晚期原发性肝癌的效果[J]．中国医药导报，2019,16(14):88-91. [5] European Association for the Study of the Liver,European Organisation for Research and Treatment of Cancer. EASLEORTC clinical practice guidelines:Management of hepatocellular carcinoma[J]. J Hepatol,2012,56(4):908-943. [6] LIU HQ,CHEN SX,LI Y,et al. Clinical observation of Kang’aiinjection with TACE in 34 patients with hepatocellular carcinoma(HC)[J]. Hainan Med J,2007,18(8):19-20.(in Chinese)刘华强，陈思现，李勇，等．康艾注射液联合肝动脉化疗栓塞术治疗肝癌34例临床观察[J]．海南医学，2007,18(8):19-20. [7] Cochrane Handbook for Systematic Reviews of Interventions Version 5. 1. 0[updated September 2011] Links Export Central Citation[EB/OL]. http://www. Cochranehandbook. org. [8] WU JL. Clinical effect of Kanglaite injection combined with interventional chemotherapy in treatment of advanced liver cancer[J]. China’s Naturopathy,2015,23(12):60-61.(in Chinese)吴进录．康莱特注射液联合介入化疗治疗中晚期肝癌的临床观察[J]．中国民间疗法，2015,23(12):60-61. [9] GAO XH. Clinical study of Kanglaite combined with interventional chemotherapy in the treatment of primary liver cancer[J]. World J Complex Medicine,2019,5(4):166-168.(in Chinese)高兴湖．康莱特联合介入化疗治疗原发性肝癌的临床研究[J]．世界复合医学，2019,5(4):166-168. [10] NIU B,ZHANG Q. Clinical observation on interventional infusion of Kanglaite on massive liver cancer[J]. J Hubei Univ Chin Med,2018,20(5):26-28.(in Chinese)牛犇，张清．巨块型肝癌介入灌注康莱特治疗的临床研究[J]．湖北中医药大学学报，2018,20(5):26-28. [11] LU DP,WANG YQ,ZHAO WL,et al. Clinical effect of Kanglaite injection combined with transarterial chemoembolization in treatment of liver cancer[J]. World Clin Med,2017,11(5):70,72.(in Chinese)路大鹏，王玉强，赵卫林，等．康莱特联合肝动脉化疗栓塞术治疗肝癌的临床研究[J]．世界临床医学，2017,11(5):70,72. [12] HU JB,WENG J,LIU SL,et al. Clinical effect of Kanglaite injection combined with interventional chemoembolization in treatment of advanced liver cancer[J]. Shanxi Oncol Medicine,2003,11(1):48-49.(in Chinese)胡建兵，翁洁，刘颂莲，等．康莱特联合介入化疗栓塞治疗中晚期肝癌疗效观察[J]．陕西肿瘤医学，2003,11(1):48-49.. [13] ZHANG YJ,CAO JH,XU XD,et al. A clinical study on Kanglaite combined with interventional chemotherapy in the treatment of primary hepatocellular carcinoma[J]. Anti-Tumor Pharm,2017,7(1):104-108.(in Chinese)张宜江，曹继华，徐兴东，等．康莱特联合介入化疗治疗原发性肝癌的临床研究[J]．肿瘤药学，2017,7(1):104-108. [14] QIN GY,ZHANG YY. Therapeutic effect of Kanglaite injection combined with intra-arterial chemotherapy in the treatment or mid and advanced primary liver cancer[J]. Zhejiang J Integr Tradit Chin West Med,1998,8(4):196-198.(in Chinese)钦光跃，张园园．康莱特联合介入化疗治疗中晚期肝癌疗效观察[J]．浙江中西医结合杂志，1998,8(4):196-198. [15] LIANG SM,WANG J,SONG J. Clinical effect of Kanglaite injection combined with interventional chemoembolization in treatment of advanced liver cancer[J]. Chin J Mod Appl Pharm,2006,23(8):825-826.(in Chinese)梁素美，王静，宋健．康莱特联合介入栓塞化疗术治疗中晚期肝癌[J]．中国现代应用药学，2006,23(8):825-826. [16] WEN FG,ZHOU LZ,HAN MJ. Clinical effect of Kanglaite injection combined with interventional treatment in treatment of liver cancer[J]. Shanxi Oncol Med,2000,8(3):187.(in Chinese)温福刚，周立中，韩铭均．康莱特联合介入治疗肝癌的临床观察[J]．陕西肿瘤医学，2000,8(3):187. [17] WANG CH,WANG ZY. Role of Kanglaite injection in multidisciplinary multimodality therapy for primary liver cancer[J].Shanxi Oncol Medicine,2001,9(3):211-212.(in Chinese)王成红，王智瑜．康莱特在原发性肝癌多学科综合治疗中的作用[J]．陕西肿瘤医学，2001,9(3):211-212. [18] WEI LN. Clinical observation of Kanglaite in the treatment of primary liver cancer[D]. Changchun:Jilin University,2019.(in Chinese)魏丽娜．康莱特治疗原发性肝癌的临床疗效观察[D]．长春:吉林大学，2019. [19] FU Y. Efficacy and safety of Kanglaite injection combined with transarterial chemoembolization in treatment of primary liver cancer[J]. Healthmust-Readmagazine,2018,19:41.(in Chinese)付远．康莱特注射液联合肝动脉化疗栓塞术治疗原发性肝癌疗效及安全性观察[J]．健康必读，2018,19:41. [20] XIE HP,LI Y,WANG FL,et al. Clinical effect of Kanglaite injection combined with transarterial chemoembolization in treatment of primary liver cancer[J]. Chin Tradit Patent Med,2018,40(12):2821-2823.(in Chinese)谢和平，李跃，王凤林，等．康莱特注射液联合肝动脉化疗栓塞术治疗原发性肝癌临床疗效[J]．中成药，2018,40(12):2821-2823. [21] LU H,ZHOU JS,XU X,et al. Effects of transcatheter arterial chemoenboliaztion combined with Kanglaite injection on patients with advanced unresectable hepatocellular carcinoma[J]. China J Prac Med,2006,33(23):3-4.(in Chinese)陆浩，周健生，徐逊，等．康莱特注射液联合肝动脉化学栓塞治疗中晚期原发性肝癌疗效观察[J]．中国实用医刊，2006,33(23):3-4. [22] ZHU XF. The clinical observation of the effect of Kanlaite injection combined with chemoembolization primary on middle and advanced stage liver cancer[J]. J Basic Clin Oncol,2006,19(2):132-134.(in Chinese)朱晓锋．康莱特注射液联合介入化疗栓塞治疗原发性中晚期肝癌[J]．肿瘤基础与临床，2006,19(2):132-134. [23] LYU DZ,ZHAO CY. Clinical effect of Kanglaite injection in the adjuvant therapy for patients after intervention for liver cancer:An analysis of 38 cases[J]. New Chin Med,2004,35(7):415-416.(in Chinese)吕徳政，赵崇瑜．康莱特注射液佐治肝癌介入术后的疗效观察──附38例报告[J]．新医学，2004,35(7):415-416. [24] LI HJ,WANG H,FANG QH,et al. Effects of Kanglaite on apoptosis and apoptotic protein procaspase-3 and caspase-9expression in hepatic carcinoma BEL-7404 cells[J]. Tumor,2010,30(9):740-743.(in Chinese)李海军，王辉，方全华，等．康莱特注射液诱导肝癌细胞凋亡及其对凋亡蛋白procaspase-3和caspase-9表达的影响[J]．肿瘤，2010,30(9):740-743. [25] LI Y,ZHAO XM,XU HL,et al. Clinical efficacy and influence of Kanglaite combined with chemotherapy on the activity of immune cells in patients with liver cancer[J]. Prog Mod Biomed,2014,14(11):2103-2106.(in Chinese)李颖，赵兴敏，徐洪亮，等．康莱特注射液配合化疗对肝癌的治疗效果及免疫细胞活性的影响[J]．现代生物医学进展，2014,14(11):2103-2106. [26] LONG Z,WANG B,TAO D,et al. Clinical research on alternating hyperfraction radiotherapy for massive hepatocellular carcinoma[J]. Oncol Lett,2015,10(1):523-527. [27] RAOUL JL,PARK JW,KANG YK,et al. Using modified RECIST and alpha-fetoprotein levels to assess treatment benefit in hepatocellular carcinoma[J]. Liver Cancer,2014,3(3-4):439-450. [28] YAN LL,NI CF,LI Z,et al. Changes in alpha-fetoprotein and des-γ-carboxy-prothrombin after transarterial chemoembolization and their value in predicting treatment outcome[J]. J Clin Hepatol,2019,35(1):109-113.(in Chinese)闫乐乐，倪才方，李智，等．肝细胞癌患者经肝动脉化疗栓塞术后AFP、脱-γ-羧基凝血酶原水平的变化及其对治疗效果的预测价值[J]．临床肝胆病杂志，2019,35(1):109-113. 期刊类型引用(10)
1. 潘明，陈勇，谢荣盛. 康莱特注射液对乙肝相关性肝癌患者恩替卡韦抗病毒活性作用的影响. 中国医学创新. 2024(06): 14-18 . 
百度学术2. 郑莉莉，黄林旗. 康莱特注射液对晚期恶性肿瘤的姑息治疗及对T淋巴细胞亚群、肿瘤标记物影响. 现代诊断与治疗. 2024(10): 1469-1470+1473 . 百度学术3. 杨华，杨建明，陈洁. 康莱特注射液联合化疗治疗晚期肺癌的疗效及对患者免疫功能、肿瘤标志物的影响. 癌症进展. 2023(02): 225-227+230 . 百度学术4. 刘志勇，周建伟，潘龙赐，葛婷，陈康海. 温阳扶正方联合肝动脉化疗栓塞术治疗脾肾阳虚型肝癌患者的临床研究. 现代肿瘤医学. 2022(03): 471-475 . 百度学术5. 史学丽，高辉，周永红，刘学臣. 康莱特注射液在恶性腹腔积液患者治疗中的作用分析. 解放军医药杂志. 2022(03): 108-111 . 百度学术6. 王杰，陈素芳，李山岭，王振兴. 顺铂热化疗灌注联合肝动脉灌注化疗栓塞术治疗肝癌的近远期效果. 中国实用医刊. 2022(14): 21-24 . 百度学术7. 龚帅昌，李洪生，涂建华，黄绍玲，邹霞，饶雪峰. 康莱特注射液（薏苡仁）对人肝癌细胞株SMMC7721自噬和凋亡的影响. 江西医药. 2021(03): 273-275 . 百度学术8. 孙原，温淑敏，谢家俊，赵万红，顾新生，孙敏. 基于网络药理学探讨康莱特注射液治疗肝癌的作用机制. 湖北医药学院学报. 2021(03): 215-221+229 . 百度学术9. 赵雯宇，司富春，王文彬，宋雪杰，杨晖. 中药注射液治疗食管癌作用研究进展. 中国实验方剂学杂志. 2021(15): 227-234 . 百度学术10. 李婷，李牧婵，刘尧，李尚点，徐春军. 中药汤剂改善原发性肝肿瘤患者生活质量的系统综述及Meta分析. 世界中西医结合杂志. 2021(06): 1002-1007 . 百度学术其他类型引用(3)
-
百度学术
下载:
