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您现在的位置:首页 => 在线期刊 => 2013年 8期 => 肝肿瘤的热消融治疗 =>肝动脉栓塞化疗联合微波消融治疗中..
肝动脉栓塞化疗联合微波消融治疗中晚期原发性肝癌的Meta分析
Meta-analysis of transarterial chemoembolization combined with microwave coagulation therapy in treatment of advanced liver cancer
文章发布日期:2013年07月12日  来源:  作者:周振东,张乐鸣,汪婷婷,等  点击次数:2191次  下载次数:505次

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【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000 01; AFP转阴率:OR=2.65,95%CI:1.73~4.07,P<0.000 1)。 结论本次研究的Meta分析结果显示TACE联合MCT治疗无法手术切除的中晚期肝癌,近远期疗效均好于单独TACE,能明显提高患者的生存率。这种联合治疗目前看来在临床上是有效的,但以上结论尚须大量高质量的临床对照研究证实。
【Abstract】:ObjectiveTo 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. MethodsA 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). ResultsA 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). ConclusionCompared 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.
【关键字】:肝肿瘤;化学栓塞,治疗性;微波消融; Meta分析
【Key words】:liver neoplasms;chemoembolization therapeutic; microwave coagulation therapy;Meta-analysis
【引证本文】:

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