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可载药微球tace对比传统tace治疗不可切除肝细胞癌患者的评估：系统性回顾和meta分析-ag捕鱼平台

文字： 2017-8-21 浏览次数：957

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evaluation of drug-eluting beads versus conventional transcatheter arterial chemoembolization in patients with unresectable hepatocellular carcinoma: a systematic review and meta-analysis

可载药微球tace对比传统tace治疗不可切除肝细胞癌患者的评估：系统性回顾和meta分析

backgroundand objectives: transcatheter arterial chemoembolization (tace) is the first-line treatment for unresectable hepatocellular carcinoma (hcc). it consists of conventional tace (ctace) and drug-eluting beads tace (deb-tace). the comparative outcomes of the two methods remain controversial. the study aim to research the optimal tace strategy for unresectable hcc.

背景和目的：经导管动脉化疗栓塞术（tace）是不可切除的肝细胞癌（hcc）的一线治疗方法。它包括传统tace（ctace）和可载药微球tace（deb-tace）。迄今，两种治疗方法的对比结果仍存在争议。本研究旨在探索适用于不可切除hcc的最佳tace治疗策略。

methods: a systematic search of keywords, including ‘hcc’ and ‘drug-eluting beads’ was performed including four electronic databases: pubmed, embase, china biological medicine database (cbm), and cochrane library databases from the date of inception to december 25, 2015. review manager 5.3 was used to calculate the pooled relative risks (rrs) and 95% confident intervals (cis).

方法：在pubmed、embase、中国生物医学文献数据库（cbm）、cochrane图书馆数据库这四个电子数据库中系统性检索自2015年12月25日至今的包含“hcc”和“drug-eluting beads”这两个关键词的临床研究。运用review manager 5.3软件计算综合相对危险度（rrs）和95%置信区间（cis）。

results: sixteen cohort studies (4 rcts, 3 prospective cohorts, 9 retrospective cohorts) were included comprising a total of 1832 patients: 822 patients with deb-tace therapy and 1010 patients undergoing ctace. the 1-, 2-, and 3-year overall survival (os) rates and 1- and 2-year relapse-free survival(rfs) rates were significantly higher in deb-tace group, with pooled rrs of 1.12 (95% ci = 1.03-1.23, p = 0.007), 1.26 (95% ci = 1.03-1.54, p = 0.02), 1.69 (95% ci = 1.00-2.84, p = 0.04), 1.21 (95% ci = 1.01-1.44, p = 0.03) and 1.68(95% ci = 1.17-2.43, p = 0.005). there was no statistical significance in 3-year rfs, tumor response and treatment related adverse events.

结果：共纳入16项研究（4个rcts，3个前瞻性研究、9个回顾性研究）包含1832例患者：822例患者接受了deb-tace治疗，1010例患者接受了ctace治疗。deb-tace组在1年、2年和3年总生存期（os）及1年、2年无复发生存期（rfs）方面显著高于ctace组，综合rrs分别为1.12（95% ci=1.03-1.23，p=0.007）、1.26（95% ci=1.03-1.54，p=0.02）、1.69（95%ci=1.00-2.84，p=0.04）、1.21（95% ci=1.01-1.44，p=0.03）。两组在3年rfs、肿瘤应答率和治疗相关不良反应发生情况方面无显著差异。

conclusions: this meta-analysis indicates the potential advantage of deb-tace in improving the 1-, 2- and 3-year os rates, and the 1- and 2-year rfs rates.

结论：相较ctace治疗，deb-tace治疗能显著提高患者1年、2年和3年总生存率及1年、2年无复发生存率。