奥曲肽治疗肝细胞癌有效性和安全性的Meta分析

张玉怀; 罗长江

doi:10.3969/j.issn.1001-5256.2015.06.023

奥曲肽治疗肝细胞癌有效性和安全性的Meta分析

DOI: 10.3969/j.issn.1001-5256.2015.06.023

兰州大学第二医院普外科

详细信息

中图分类号: R735.7
计量
- 文章访问数: 2006
- HTML全文浏览量: 16
- PDF下载量: 554
- 被引次数: 0
出版历程
- 出版日期: 2015-06-20

Efficacy and safety of octreotide in treatment of hepatocellular carcinoma: a meta-analysis

摘要

摘要:
目的系统评价奥曲肽治疗肝细胞癌的有效性和安全性。方法系统检索Pub Med、Cochrane图书馆、EMBASE、中国期刊全文数据库(CNKI)、万方数据库和中文科技期刊数据库(VIP)中关于奥曲肽治疗肝细胞癌的随机对照试验(RCT)。采用Cochrane系统评价手册推荐的方法评价纳入研究质量,数据分析采用Rev Man 5.3.4软件。结果纳入11项RCT,共909例患者,其中试验组452例,对照组457例。在临床疗效方面,奥曲肽显著提高了临床有效率[RR=2.30,95%可信区间(95%CI):1.25~4.22,P=0.007]和降低了疾病进展率(RR=0.78,95%CI:0.59~1.04,P=0.09),而疾病控制率两组间差异无统计学意义(P>0.05);在生存率方面,两组患者总生存率、6个月、1年和2年生存率差异均无统计学意义(P值均>0.05);在安全性方面,试验组的严重并发症显著减少(RR=0.72,95%CI:0.54~0.98,P=0.03),而在腹泻、恶心/呕吐、肝功能异常和血糖波动方面差异无统计学意义(P值均>0.05)。结论奥曲肽治疗肝细胞...
- 癌,肝细胞 /
- 奥曲肽 /
- Meta分析
Abstract:
Objective To systematically evaluate the efficacy and safety of octreotide in the treatment of hepatocellular carcinoma( HCC).Methods Online databases including Pub Med,Cochrane Library,Embase,China National Knowledge Internet,Wanfang Data,and China Science and Technology Journal Database were comprehensively searched for relevant randomized controlled trials( RCTs) of octreotide in the treatment of HCC. The quality of included studies was assessed using the method recommended by the Cochrane handbook for systematic review. A meta- analysis was performed by using Rev Man 5. 3. 4 software. Results Eleven RCTs were included,which involved 909 cases( treatment group,452 cases; control group,457 cases). As for clinical efficacy,octreotide significantly increased the response rate( RR =2. 30,95% CI: 1. 25 ~ 4. 22,P = 0. 007) and decreased the progression rate( RR = 0. 78,95% CI: 0. 59 ~ 1. 04,P = 0. 09),but there was no significant difference in disease control rate and progression rate between the two groups( P > 0. 05). The overall survival rate and6- month,1- year,and 2- year survival rates in the treatment group were not significantly higher than those of the control group( all P >0. 05). As regards to safety,severe adverse events in the treatment group were significantly reduced( RR = 0. 72,95% CI: 0. 54 ~ 0. 98,P= 0. 03),but there were no significant differences in diarrhea,nausea / vomiting,liver function abnormality,and blood glucose fluctuation between the two groups( all P > 0. 05). Conclusion For HCC patients,octreotide can significantly increase the clinical response rate incidence of grade 3 /4 adverse events,but it does not lead to significant improvement in disease progression and survival rate.
- carcinoma,hepatocellular /
- octreotide /
- Meta-analysis

HTML全文

参考文献(19)

[1]JIANG L,CHENG Q,ZHANG BH,et al.Circulating MicroRNAs as biomarkers in hepatocellular carcinoma screening:a validation set from China[J].Medicine,2015,94(10):e603.

[2]CHEN JG,ZHANG SW.Liver cancer epidemic in China:past,present and future[C].Semin Cancer Biol,2011,21(1):59-69.

[3]BRUIX J,SHERMAN M,LLOVET J M,et al.Clinical management of hepatocellular carcinoma.Conclusions of the Barcelona-2000 EASL conference[J].J Hepatol,2001,35(3):421-430.

[4]Glatstein M,Scolnik D,Bentur Y.Octreotide for the treatment of sulfonylurea poisoning[J].Clin Toxicol(phila),2012,50(9):795-804.

[5]CHEN JS,LIANG QM.Efficacy of somatostatin in treatment of gastrointestinal cancer[J].China Pharm,2007,18(8):632-634.(in Chinese)陈劲松,梁庆模.生长抑素对胃肠癌的治疗[J].中国药房,2007,18(8):632-634.

[6]XIA YL,ZHANG CQ,WANG GC,et al.Individual and combined effects of octreotide and terlipressin on hepatic venous pressure gradient in cirrhotic patients[J].J Clin Hepatol,2015,31(2):214-218.(in Chinese)夏玉莲,张春清,王广川,等.奥曲肽和特利加压素单用或联用对肝硬化患者肝静脉压力梯度的影响[J].临床肝胆病杂志,2015,31(2):214-218.

[7]YUEN MF,POON RTP,LAI CL,et al.A randomized placebo-controlled study of long-acting octreotide for the treatment of advanced hepatocellular carcinoma[J].Hepatology,2002,36(3):687-691.

[8]BECKER G,ALLGAIER HP,OLSCHEWSKI M,et al.Longacting octreotide versus placebo for treatment of advanced HCC:a randomized controlled double-blind study[J].Hepatology,2007,45(1):9-15.

[9]DIMITROULOPOULOS D,XINOPOULOS D,TSAMAKIDIS K,et al.Long acting octreotide in the treatment of advanced hepatocellular cancer and overexpression of somatostatin receptors:randomized placebocontrolled trial[J].World J Gastroenterol,2007,13(23):3164-3170.

[10]VERSET G,VERSLYPE C,REYNAERT H,et al.Efficacy of the combination of long-acting release octreotide and tamoxifen in patients with advanced hepatocellular carcinoma:a randomised multicentre phase III study[J].Br J Cancer,2007,97(5):582-588.

[11]BARBARE JC,BOUCHO,BONNETAIN F,et al.Treatment of advanced hepatocellular carcinoma with long-acting octreotide:a phase III multicentre,randomised,double blind placebo-controlled study[J].Eur J Cancer,2009,45(10):1788-1797.

[12]WANG Y,PENG CH,LIU YB,et al.Octreotide in combination with TACE in prevention of relapse and metastasis after radical operation forprimary hepatocellular carcinoma[J].Chin J Hepatobiliary Surg,2004,10(9):594-596.(in Chinese)王涌,彭承宏,刘颖斌,等.奥曲肽联合肝动脉栓塞化疗预防肝癌术后复发转移的临床研究[J].中华肝胆外科杂志,2004,10(9):594-596.

[13]ZHANG B,XU F.The clinical observation of octreotide in the treatment of 45 patients with advance primary liver carcinoma[J].J Basic Clin Oncol,2010,23(1):52-53.(in Chinese)张兵,徐峰.奥曲肽治疗晚期肝癌45例临床观察[J].肿瘤基础与临床,2010,23(1):52-53.

[14]ZHANG DY.Clinical efficacy of octreotide in treatment of advanced primary liver cancer:a report of 30 cases[J].China Prac Med,2012,7(2):142-143.(in Chinese)张大悦.奥曲肽治疗30例晚期原发性肝癌的临床观察[J].中国实用医药,2012,7(2):142-143.

[15]REN XL.Clinical efficacy of octreotide combined with conventional chemotherapy drugs in treatment of advanced primary liver cancer[J].China Health Industry,2014,10(30):65.(in Chinese)任晓龙.奥曲肽联合常规化疗药物治疗中晚期原发性肝癌的临床研究[J].中国卫生产业,2014,10(30):65.

[16]CHEN YH,OU SQ,CHENG WM,et al.Clinical study of octreotide for advance hepatocellular carcinoma[J].J Mod Oncol,2010,18(9):1793-1794.(in Chinese)陈逸恒,欧盛秋,程伟民,等.奥曲肽治疗晚期原发性肝癌的疗效观察[J].现代肿瘤医学,2010,18(9):1793-1794.

[17]JIANG BG,ZANG JL,SUN GF.The clinical study of octreotide for advanced primary hepatic cancer[J].J Mod Oncol,2009,17(5):884-885.(in Chinese)蒋伯刚,臧家兰,孙贵富.奥曲肽治疗晚期原发性肝癌的临床观察[J].现代肿瘤医学,2009,17(5):884-885.

[18]TROTTI A,COLEVAS AD,SSTSER A,et al.CTCAE v3.0:development of a comprehensive grading system for the adverse effects of cancer treatment[C].Seminars in radiation oncology,2003,13(3):176-181.

[19]CHEN YX.New trends in response evaluation criteria for antitumor drugs[J].Chin J Clin Oncol Rehabil,2000,7(6):1-3.(in Chinese)陈运贤.抗肿瘤药的疗效评价标准新动向[J].中国肿瘤临床与康复,2000,7(6):1-3.

施引文献

资源附件(0)

访问统计