恒瑞医疗 网址: www.hrmedical.com.cn

专业文献

三氧化二砷联合肝动脉栓塞化疗治疗不可切除原发性肝癌:一项系统性回顾和荟萃分析-ag捕鱼平台

文字: 2018-6-8    浏览次数:761    

background:primary hepatic carcinoma (phc) is the third commonest leading to cancer death around the world, and transarterial chemoembolization(tace) has been proposed as the first-line therapeutic treatment for patients with unresectable phc. this study aims to determine whether the combination of as2o3 and tace is superior to alone tace for achieving more clinical therapeutic efficacy,survival time, life quality and safety in patients with unresectable phc.

背景:全球范围内,原发性肝癌(phc)是排名第三的癌症死亡原因,肝动脉栓塞化疗(tace)被推荐为不可切除phc患者的一线治疗方案。本研究的目的是评估三氧化二砷联合tace与单用tace治疗不可切除phc相比,在临床疗效、生存时间、生活质量和安全性上是否更具优势。

methods:a comprehensive literature search was conducted on the clinical controlled trials comparing therapeutic effects of as2o3& tace versus alone tace for unresectable phc through english databases(including pubmed, embase, and the cochrane library) and chinese databases(including china knowledge resource integrated database, wanfang database,weipu database, and chinese biomedical database). the last search was in 30 august 2017. a recursive search was performed with bibliographies of relevantstudies. there were no language restrictions. primary outcomes, defined a priori, were therapeutic responses (clinical effective rate and clinical benefit rate), survival time, life quality, and adverse events of as2o3 & tace compared with alone tace expressed as relative risk (rr) with 95% confidence intervals (ci).

方法:在中英文数据库中(英文:pubmed, embasethe cochrane library;中文:中国知识资源总库,万方,维普和中国生物医学数据库)对三氧化二砷联合tace对比单用tace治疗不可切除phc的对照研究进行全面的搜索。最后一次搜索时间2017830日。通过相关研究的参考文献进行递归搜索,没有语言限制。先验定义的主要终点是三氧化二砷联合tace对比单用tace的治疗反应(临床有效率和临床获益率),生存时间,生活质量和不良事件,表达为相对风险(rr)和95%有效区间(ci)。

results: 25 clinical controlled trials involving 1886 participants were included. we found that there were significant superiority associated with as2o3& tace compared with alone tace in clinical benefit rate (rr: 1.24,95% ci: 1.12–1.37), clinical effective rate (rr: 1.35, 95% ci: 1.17–1.55), 2-year survival rate (rr: 1.45,95% ci: 1.20–1.75), and improving of kps (rr: 1.31, 95% ci: 1.14–1.50). these associations were also observed in subgroups by intervened methods of as2o3 andpulmonary metastasis. notably, the pooled relative risk of retention of sodium and water was obviously raised in patients with as2o3 & tace therapy (rr: 16.616, 95% ci: 8.01 – 34.486).

结果:共纳入25个临床对照研究,1886名受试者。三氧化二砷联合tace与单用tace相比显著提高临床获益率(rr: 1.24,95% ci:1.12–1.37),临床有效率(rr: 1.35, 95% ci:1.17–1.55)2年生存率(rr: 1.45, 95% ci:1.20-1.75)kps改善率 (rr: 1.31, 95% ci:1.14-1.50)。不同三氧化二砷给药方法和肺转移亚组中均观察到同样的结果。值得注意的是,三氧化二砷联合tace治疗组的水钠储留汇总发生风险明显升高(rr: 16.616, 95% ci:8.01 - 34.486)

conclusion:the superiority of adjuvant as2o3 therapy combined with tace in phc individuals will outweigh alone tace therapy,especially in phc populations with pulmonary metastasis.

结论:phc患者接受三氧化二砷联合tace辅助治疗优于tace单独应用,特别是肺转移的phc患者。