肝动脉化疗栓塞术联合~(125)I放射性粒子植入术与单独肝动脉化疗栓塞术治疗肝癌的meta分析
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摘要
目的对比肝动脉化疗栓塞术(TACE)联合~(125)I粒子植入术与单独TACE治疗肝癌的临床疗效。方法计算机检索关于TACE联合~(125)I粒子植入术与单独TACE治疗肝癌的随机对照试验(RCT)研究,纳入分析近期、远期疗效及并发症。结果纳入7篇RCT,498例患者,meta分析结果:联合组的完全缓解(CR)、部分缓解(PR)、稳定(SD)、1、2、3年生存率明显高于单纯治疗组,而进展(PD)明显低于单纯治疗(对照)组,P<0.05差异均有统计学意义,并发症方面两组均未出现放射性邻近器官坏死及全身严重不良反应,对症治疗可缓解。结论 TACE联合125I放射性粒子植入术治疗肝癌疗效优于单独TACE治疗。
Objective To compare the curative effect and safety of transcatheter arterial chemoembolization(TACE) combined with ~(125)I seed implantation with those of simple TACE in treating liver cancers. Methods Computerized retrieval of randomized controlled trial(RCT) concerning TACE combined with125 I seed implantation(combined treatment group) and TACE alone(pure TACE group) for the treatment of liver cancers was conducted. The short-term, long-term outcomes and complications were enrolled in the scope of analysis. Results A total of 7 randomized controlled trials, including 498 patients in total, were enrolled in this study. Meta analysis indicated that complete remission(CR) rate, partial remission(PR) rate,stable disease(SD) rate and one-year, 2-year, 3-year survival rates in the combined treatment group were significantly higher than those in the pure TACE group, while progression disease(PD) rate in the combined treatment group was remarkably lower than that in the pure TACE group, and the differences in all above indexes between the two groups were statistically significant(P<0.05). No radiation necrosis of adjacent organs or severe systemic adverse reactions occurred in both groups. Slight adverse reactions could be alleviated through symptomatic treatment. Conclusion In treating liver cancers, the curative effect of TACE combined with ~(125)I seed implantation is better than that of TACE alone.
Objective To compare the curative effect and safety of transcatheter arterial chemoembolization(TACE) combined with ~(125)I seed implantation with those of simple TACE in treating liver cancers. Methods Computerized retrieval of randomized controlled trial(RCT) concerning TACE combined with125 I seed implantation(combined treatment group) and TACE alone(pure TACE group) for the treatment of liver cancers was conducted. The short-term, long-term outcomes and complications were enrolled in the scope of analysis. Results A total of 7 randomized controlled trials, including 498 patients in total, were enrolled in this study. Meta analysis indicated that complete remission(CR) rate, partial remission(PR) rate,stable disease(SD) rate and one-year, 2-year, 3-year survival rates in the combined treatment group were significantly higher than those in the pure TACE group, while progression disease(PD) rate in the combined treatment group was remarkably lower than that in the pure TACE group, and the differences in all above indexes between the two groups were statistically significant(P<0.05). No radiation necrosis of adjacent organs or severe systemic adverse reactions occurred in both groups. Slight adverse reactions could be alleviated through symptomatic treatment. Conclusion In treating liver cancers, the curative effect of TACE combined with ~(125)I seed implantation is better than that of TACE alone.
引文
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[9]王朝栋,党国际,陈锦州,等.经皮肝动脉碘油化疗栓塞联合CT引导下125I放射性粒子植入治疗巨块型肝癌[J].中国伤残医学,2015,23:12-14.
[10]肖利军.初治原发性肝癌TACE前后VEGF的变化分析及对疗效的评估[D].广州:南方医科大学,2016:1-51.
[11]梁宇,段留新,郝法涛,等.血清VEGF对肝癌TACE治疗疗效的判断价值[J].肿瘤药学,2017,7:355-359.
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[13]沈颖甜,朱海东,陈荔,等.肝内胆管细胞癌诊疗研究进展[J].介入放射学杂志,2018,27:285-289.
[14]黄宁,杨维竹,江娜,等.经导管动脉化疗栓塞术联合经皮125I粒子植入序贯治疗肝癌伴门静脉主干癌栓[J].中华介入放射学电子杂志,2014,2:11-15.
[2]姚红响,陈根生,诸葛英,等.肝动脉化疗栓塞联合CT引导射频消融序贯治疗中小肝癌的临床应用[J].介入放射学杂志,2012,21:301-304.
[3]欧盛秋,韦长元,马亦龙,等.125I放射性粒子联合TACE治疗原发性肝癌的临床观察[J].中华肿瘤防治杂志,2014,21:1373-1375.
[4]李庆,曹苏娟,龙文兴,等.125I粒子植入术联合TACE治疗大肝癌的临床效果[J].中国医药导报,2016,13:73-77.
[5]严丽,曾兆云,熊宗恒,等.125I粒子植入联合肝动脉化疗栓塞治疗晚期肝癌的临床疗效[J].医学临床研究,2016,33:2449-2451.
[6]曹贵文,杜苗苗,崔新江,等.TACE联合125I放射性粒子植入序贯治疗近心旁原发性肝细胞肝癌效果观察[J].山东医药,2017,57:55-57.
[7]金光鑫,王智,王军,等.肝动脉化疗栓塞联合125I粒子植入治疗原发性肝癌的临床研究[J].实用癌症杂志,2016,31:1957-1959.
[8]李靖,肖金成,郑琳,等.含洛铂方案经肝动脉化疗栓塞联合125I粒子植入术治疗不能手术的中晚期肝癌的疗效观察[J].中国癌症杂志,2017,27:896-902.
[9]王朝栋,党国际,陈锦州,等.经皮肝动脉碘油化疗栓塞联合CT引导下125I放射性粒子植入治疗巨块型肝癌[J].中国伤残医学,2015,23:12-14.
[10]肖利军.初治原发性肝癌TACE前后VEGF的变化分析及对疗效的评估[D].广州:南方医科大学,2016:1-51.
[11]梁宇,段留新,郝法涛,等.血清VEGF对肝癌TACE治疗疗效的判断价值[J].肿瘤药学,2017,7:355-359.
[12]冉琳,任伯绪.125I粒子组织间近距离放射治疗肝癌的现状与进展[J].介入放射学杂志,2012,21:876-878.
[13]沈颖甜,朱海东,陈荔,等.肝内胆管细胞癌诊疗研究进展[J].介入放射学杂志,2018,27:285-289.
[14]黄宁,杨维竹,江娜,等.经导管动脉化疗栓塞术联合经皮125I粒子植入序贯治疗肝癌伴门静脉主干癌栓[J].中华介入放射学电子杂志,2014,2:11-15.