经导管动脉化疗栓塞术联合射频消融术治疗大肝癌的疗效及安全性的Meta分析

摘要/Abstract

摘要： 目的: 通过Meta分析,与单纯经导管动脉化疗栓塞术（transcatheter arterial chemoembolization,TACE）对比,分析TACE联合射频消融术（radiofrequency ablation,RFA）治疗大肝癌的疗效及安全性。
方法: 按照Meta分析流程界定检索词检索PubMed、Embase、Seer、Cochrane Library、中国知网、万方医学网、维普和中国生物医学文献数据库等国内外相关数据库,检索时间为2003年1月至2023年6月。筛选并纳入TACE+RFA与单纯TACE治疗大肝癌疗效及安全性的临床随机对照研究,对纳入研究进行质量评价,并采用RevMan5. 4 软件进行Meta分析。
结果: 最终纳入16篇文献。TACE+RFA组患者587例,TACE组患者588例,共1175例。Meta分析结果显示,TACE+RFA组大肝癌患者的客观缓解率（objective response rate,ORR）[相对危险度（relative risk,RR）=1.46,95%置信区间（95% confidence interval,95%CI）：1.35~1.59,P<0.000 01]、疾病控制率（disease control rate,DCR）（RR=1.17,95%CI：1.12~1.22,P<0.000 01）及1年总生存率（RR=1.39,95%CI：1.24~1.55,P<0.000 01）、2年总生存率（RR=1.79,95%CI：1.38~2.32,P<0.000 1）、3年总生存率（RR=3.20,95%CI：1.25~8.20,P=0.02）均优于单纯TACE组大肝癌患者。两组患者治疗后不良反应发生率的差异无统计学意义。
结论: 与单纯TACE相比,TACE+RFA可提高大肝癌患者近期疗效和提高患者远期总生存率,且未增加不良反应的发生。

关键词: 大肝癌, 经导管动脉化疗栓塞术, 射频消融术, Meta分析

Abstract: Objective: Through Meta-analysis, compared with transcatheter arterial chemoembolization (TACE) alone, to analyze the curative effect and safety of TACE combined with radiofrequency ablation (RFA) in treating large liver cancers.
Method: According to the Meta-analysis process, the relevant domestic and foreign related databases such as PubMed, Embase, Seer, Cochrane Library, CNKI, Wanfang Medical Network, VIP, China Biomedical Literature Database were searched with defined search terms. The search period was January 2003 to June 2023. Randomized controlled clinical studies on the efficacy and safety of TACE+RFA versus TACE alone in the treatment of large liver cancer were screened and included. The quality of the included studies was evaluated and Meta-analysis was performed using RevMan5.4 software. Result:Finally, A total of 16 papers were included, involving 1 175 patients, including 587 cases in the TACE+RFA group and 588 cases in the TACE alone group. The results of Meta-analysis indicated that: compared with the TACE alone group, the objective response rate (ORR) [relative risk (RR)=1.46, 95% confidence interval (95%CI): 1.35-1.59, P<0.000 01], disease control rate (DCR) (RR=1.17, 95%CI: 1.12-1.22, P<0.000 01), 1-year survival rate (RR=1.39, 95%CI: 1.24-1.55, P<0.000 01), 2-year survival rate (RR=1.79, 95%CI: 1.38-2.32, P<0.000 1) and 3-year survival rate (RR=3.20, 95%CI: 1.25-8.20, P=0.02) of TACE+RFA group were better than those of simple TACE group, and the difference was statistically significant. There was no significant difference in the common adverse reactions between the two groups.
Conclusion: Compared with TACE alone, TACE+RFA can improve the short-term efficacy and the long-term survival rate of large liver cancer patients, and does not increase the occurrence of adverse reactions.

Key words: Large liver cancer, Radiofrequency ablation, Transcatheter arterial chemoembolization, Meta-analysis

李梅, 乔蓓, 张志豪. 经导管动脉化疗栓塞术联合射频消融术治疗大肝癌的疗效及安全性的Meta分析[J]. 肝癌电子杂志, 2024, 11(1): 9-15.

Li Mei, Qiao Bei, Zhang Zhihao. A Meta-analysis of the curative effect and safety of transcatheter arterial chemoembolization combined with radiofrequency ablation in the treatment of large liver cancer[J]. Electronic Journal of Liver Tumor, 2024, 11(1): 9-15.

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