肝动脉栓塞化疗联合微波消融治疗中晚期肝癌的Meta分析

周振东; 张乐鸣; 汪婷婷; 孙小可; 陈亮亮; 刘魁

doi:10.3969/j.issn.1001-5256.2013.08.010

肝动脉栓塞化疗联合微波消融治疗中晚期肝癌的Meta分析

DOI: 10.3969/j.issn.1001-5256.2013.08.010

1. 宁波大学医学院
2. 宁波第一医院
3. 武汉大学人民医院感染性疾病科

详细信息

中图分类号: R735.7
计量
- 文章访问数: 296
- HTML全文浏览量: 24
- PDF下载量: 257
- 被引次数: 0
出版历程
- 收稿日期: 2013-01-12
- 出版日期: 2013-08-20

Meta-analysis of transarterial chemoembolization combined with microwave coagulation therapy in treatment of advanced liver cancer

摘要

摘要:
目的评价肝动脉栓塞化疗（TACE）联合微波消融（MCT）治疗中晚期肝癌的临床疗效,为该方法在临床推广提供更具有说服力的科学依据。方法计算机检索Cochrane Library、PubMed、EM-base、CBM、CNKI、VIP WanFang Data,并同时应用其他检索,纳入TACE和MCT联合用于中晚期原发性肝癌的临床对照试验,根据标准选择纳入文献,按Cochrane系统评价方法评价纳入研究质量,对同质研究采用RevMan5.0软件进行Meta分析。研究指标为TACE+MCT组与对照组0.5、1、2 a生存率及甲胎蛋白（AFP）转阴率采用比值比（OR）及其95%置信区间（CI）.结果按照入选标准,纳入12个研究共872例。Meta分析结果显示,TACE联合MCT组与单纯TACE组相比,其0.5、1、2年生存率、总有效率差异均有统计学意义（0.5年生存率:OR=7.21,95%CI:1.92～27.08,P=0.003;1年生存率:OR=4.47,95%CI:3.14～6.36,P<0.000 01;2年生存率:OR=3.66,95%CI:2.45～4.84,P<0....
- 肝肿瘤 /
- 化学栓塞,治疗性 /
- 微波消融 /
- Meta分析
Abstract:
Objective To evaluate the clinical efficacy of transarterial chemoembolization (TACE) combined with microwave coagulation therapy (MCT) in the treatment of advanced liver cancer and to provide a more convincing basis for the clinical application of this therapy.Methods A search was performed using Cochrane Library, PubMed, Em-base, CBM, CNKI, VIP WanFang Data as well as other sources to collect randomised controlled trials (RCTs) of TACE combined with MCT in the treatment of advanced primary liver cancer.The literature was selected according to inclusion criteria.The quality of included studies was assessed according to Cochrane review criteria.A Meta-analysis was performed on homogeneous studies using RevMan 5.0.The patients receiving TACE combined with MCT were compared with those receiving TACE alone in terms of 0.5-year, 1-year, and 2-year survival rates and negative conversion rate of alpha-fetoprotein (AFP) .Results A total of 12 RCTs involving 872 cases were included in the analysis.Compared with those receiving TACE alone, the patients receiving TACE combined with MCT had a significantly higher 0.5-year survival rate (OR=7.21, 95% CI: 1.92-27.08, P=0.003) , a significantly higher 1-year survival rate (OR=4.47, 95% CI:3.14-6.36, P<0.000 01) , a significantly higher 2-year survival rate (OR=3.66, 95% CI:2.45-4.84, P<0.000 01) , and a significantly higher negative conversion rate of AFP (OR=2.65, 95% CI:1.73-4.07, P<0.000 1) .Conclusion Compared with TACE alone, TACE combined with MCT can produce better short-term and long-term treatment outcomes and significantly improve the survival rate in patients with unresectable advanced liver cancer, according to the meta-analysis.This combination therapy might be clinically effective, but which needs to be confirmed by a large number of high-quality controlled clinical trials.
- liver neoplasms /
- chemoembolization therapeutic /
- microwave coagulation therapy /
- Meta-analysis

HTML全文

参考文献(22)

[1]XU LF, CHEN YT, REN Q, et al.Clinical application of transarterial chemoembolization combining with air-cooled percutaneous microwave coagulation therapy on patients with primary hepatic carcinoma[J].Chin J Clin Oncol, 2007, 34 (10) :553-557. (in Chinese) 许林峰, 陈耀庭, 任强, 等.TACE联合冷循环PMCT治疗原发性肝癌的临床应用[J].中国肿瘤临床, 2007, 34 (10) :553-557.

[2]GAO BY, LIU Y, XIA LP, et al.Clinical review of transarterial chemoembolization combining with percutaneous microwave coagula-tion therapy on advanced liver cancer[J].J Hainan Med Coll, 2012, 18 (9) :1228-1231. (in Chinese) 高炳玉, 刘玉, 夏立平, 等.肝动脉灌注化疗栓塞联合微波消融治疗中晚期肝癌的疗效观察[J].海南医学院学报, 2012, 18 (9) :1228-1231.

[3]QIU SM, CHEN G, LI HB, et al.Clinical observation of the union treatment of hepatic transcatheter arterial chemoembolization and percutaneous microwave coagulation therapy for hepatic cellular car-cinoma[J].Mod Med J, 2011, 39 (5) :526-529. (in Chinese) 邱少敏, 陈刚, 李宏波, 等.肝动脉化疗栓塞联合经皮微波凝固疗法治疗中晚期肝癌的临床观察[J].现代医学, 2011, 39 (5) :526-529.

[4]CHEN G, TANG XJ, LI HB, et al.Evaluation on curative effect of TACE combined with microwave ablation for hepatic cellular carci-noma with moderate and advanced stage[J].J Clin Radiol, 2012, 31 (5) :710-713. (in Chinese) 陈刚, 唐晓军, 李宏波, 等.肝动脉化疗栓塞联合经皮微波消融治疗中晚期肝癌的疗效评价[J].临床放射学杂志, 2012, 31 (5) :710-713.

[5]WEI ZH, LU JX, PU J, et al.Clinical review of transcatheter he-patic arterial chemoembolization combined with microwave ablation for recurrent hepatocellular carcinoma[J].Guangxi Med J, 2011, 33 (9) :1131-1132. (in Chinese) 韦忠恒, 陆建勋, 浦涧, 等.肝动脉化疗栓塞联合微波消融治疗复发性肝癌的研究[J].广西医学, 2011, 33 (9) :1131-1132.

[6]MA WJ, GUO SS, ZHANG LC, et al.Clinical review of transcath-eter hepatic arterial chemoembolization combined with microwave ablation in patients with liver cancer[J].Mod Med J Chin, 2012, 14 (5) :28-30. (in Chinese) 马文静, 郭双双, 张立成, 等.肝动脉化疗栓塞联合微波消融治疗肝癌的临床研究[J].中国现代医药杂志, 2012, 14 (5) :28-30.

[7]LIU JX.Combination of transcatheter arterial chemo-embolization and percutaneous microwave coagulation therapy in the treatment of hepatocellular carcinoma[J].J Minim Inva Med, 2010, 5 (4) :333-335. (in Chinese) 刘锦新.肝动脉化疗栓塞联合微波消融治疗肝细胞癌的研究[J].微创医学, 2010, 5 (4) :333-335.

[8]ZHANG CG, WANG GL.Evaluation on curative effect of transarterial chemoembolization combined with microwave ablation for hepatic cellu-lar carcinoma[J].J Clin Hepatol, 2011, 14 (5) :378-379. (in Chi-nese) 张崇高, 王国林.肝动脉化疗栓塞联合微波消融治疗原发性肝癌临床疗效分析[J].实用肝脏病杂志, 2011, 14 (5) :378-379.

[9]XIN BQ, LI GH, CUI WG.Evaluation on curative effect of tACE combined with microwave ablation for hepatic cellular carcinoma with moderate and advanced stage[J].J Med Radiol Technol, 2004, 223 (3) :47-48. (in Chinese) 辛本强, 李光华, 崔维刚.肝动脉栓塞化疗联合微波凝固治疗中晚期肝癌的评价[J].医用放射技术杂志, 2004, 223 (3) :47-48.

[10]ZHAO C, MA YL, KANG P, et al.Clinical review of transcatheter hepatic arterial chemoembolization combined with microwave abla-tion in patients with advanced liver cancer[J].Chin J of Oncol prev and Treat, 2009, 1 (3) :218-220. (in Chinese) 赵昌, 马亦龙, 康平, 等.经肝动脉化疗栓塞联合微波消融治疗中晚期肝癌的临床疗效观察[J].中国癌症防治杂志, 2009, 1 (3) :218-220.

[11]XIANG H, LONG L, ZHANG ZM, et al.The clinical efficacy of the combination interventional therapy large hepatocellular carcino-ma[J].J Nanhua Univ:Med Edition, 2007, 35 (5) :761-763. (in Chinese) 向华, 龙林, 张智明, 等.联合介入治疗大肝癌的临床疗效分析[J].南华大学学报:医学版, 2007, 35 (5) :761-763.

[12]CHENG CS, TANG WG, WANG CQ, et al.Clinical review of micro-wave coagulation combining with transarterial chemoembolization thera-py on patients with primary hepatic carcinoma[J].J Minim Inva Med, 2012, 7 (2) :131-132. (in Chinese) 程昌盛, 汤伟光, 王春清, 等.微波消融联合肝动脉栓塞化疗术治疗中晚期肝癌的临床研究[J].微创医学, 2012, 7 (2) :131-132.

[13]XU LF, SUN HL, CHEN YT, et al.Large primary hepatocellular carcinoma:TACE monotherapy versus combined transarterial che-moembolization-percutaneous microwave coagultaion thera py.[J].Gastroenterol Hepatol, 2013, 28 (3) :456-463.

[14]GOLDSTEIN HM, WALLACE S, ANDERSON JH, et al.Tran scatheter occlusion of abdominal tumors[J].Radiology, 1976, 120 (3) :539-545.

[15]CHEN MS, LI JQ, ZHANG YQ, et al.High-dose iodized oil tran-scatheter arterial chemoembolization for patients with large hepa-tocellularcarcinoma[J].World J Gastroenterol, 2002, 8 (1) :74-78.

[16]HU DS, LI Z, WANG N, et al.TACE treatment of hepatic carcinoma:a comparative study of low dose versus conventional dose[J].J Clin Radiol, 2004, 23 (16) :502-506. (in Chinese) 胡道予, 李震, 王南, 等.小剂量与常规剂量化疗药物经动脉化疗栓塞术治疗肝癌的对照研究[J].临床放射学杂志, 2004, 23 (6) :502-506.

[17]YAMADA R, SATO M, KAWABATA M, et al.Hepatic artery em-bolization in120patients with unresectable hepatoma[J].Radiolo-gy, 1983, 148 (2) :397-401.

[18]ACHENBACH T, SEIFERT JK, PITTON MB, et al.Chemoembo-lization for primary liver cancer[J].Eur J Surg Oncol, 2002, 28 (1) :37-41.

[19]YAN F.Clinical efficacy of double-intervention treatment of ad-vanced liver cancer[J].J Clin Exp Med, 2011, 10 (16) :1282-1283. (in Chinese) 严峰, 双介入治疗中晚期肝癌的临床效果观察[J].临床和实验医学杂志, 2011, 10 (16) :1282-1283.

[20]TABUSE Y, TABUSE K, MORI K, et aI.Percutaneous microwave tis-sue coagulation in liver biopsy:experimental and clinical studies[J].Nippon Geka Hokan, 1986, 55 (3) :381-392.

[21]SEKI T, WAKABAYASHI M, NAKAGAWA T, et al.Ultrasonically guided pereutaneous microwave coagulation therapy for small hepatocel-lular carcinoma[J].Cancer, 1994, 74 (3) :817-821.

[22]LIU JY, LU W, ZHOU YH, et al.The clincial observation of sono-graphically guided percutaneous microwave coagulation of liver tumors abutting[J].J Clin Hepatol, 2011, 27 (4) :375-377. (in Chinese) 刘建勇, 陆伟, 周永和, 等.超声引导下经皮微波消融治疗邻近危险区域肝癌临床观察[J].临床肝胆病杂志, 2011, 27 (4) :375-377.

施引文献

资源附件(0)

访问统计