TACE联合阿帕替尼治疗中晚期肝癌临床疗效与安全性的meta分析

摘要/Abstract

摘要： 目的运用临床荟萃分析经导管肝动脉化疗栓塞(TACE)联合阿帕替尼治疗中晚期肝癌的疗效和安全性。方法在计算机上检索从建库至2019年5月的关于研究TACE联合阿帕替尼与单一TACE治疗中晚期肝癌的随机对照试验(RCT),主要的检索数据库包括Sciencedirect 、Pubmed、Embase、考克兰图书馆、万方数据库、中国生物医学文献数据库、中文科技期刊数据库。按照Cochrane系统评价方法完成数据提取和文献质量评估。最后,使用Revman5.3软件分析数据。结果在检索分析后有6篇RCT入组,共308例患者,这些患者的客观缓解率(ORR)在TACE+阿帕替尼组和TACE组分别为51.31%和23.38%,差异有统计学意义(P<0.000 01),疾病控制率(DCR)在TACE+阿帕替尼组和TACE组分别为78.95%和52.60%,前者明显高于后者,P=0.02;而且TACE+阿帕替尼组有较高的半年、1年、2年生存率;阿帕替尼联合治疗组的不良反应明显高于单纯TACE组,不良反应主要是高血压、发热、蛋白尿等,经对症治疗后均有改善,无其他严重不良反应。结论根据分析得出结论,阿帕替尼联合TACE治疗中晚期肝癌的临床疗效和安全性是明显的。

关键词: 经导管肝动脉化疗栓塞, 阿帕替尼, 中晚期肝癌, 疗效, 安全性, Meta分析

Abstract: Objective To evaluate the efficacy and safety of TACE combined with apatinib in the treatment of advanced liver cancer.Methods A randomized controlled trial (RCT) was conducted on a computer from the establishment of the library to May 2019 for the study of TACE combined with apatinib and single TACE in the treatment of advanced liver cancer. The main search databases include Sciencedirect, Pubmed, Embase, and Cork. Lan Library, Wanfang Database, China Biomedical Literature Database, Chinese Science and Technology Periodical Database. Data extraction and literature quality assessment were performed according to the Cochrane systematic review method. Finally, the data was analyzed using Revman 5.3 software.Results After the search and analysis, there were 6 RCTs enrolled in a total of 308 patients. The Objective response rate (ORR) of these patients was 43.31% and 23.38%, respectively. The difference was statistically significant (P<0.000 01), the disease control rate (DCR) of TACE+apatinib group and TACE group were 78.95%, 52.60%, the former was significantly higher than the latter, P=0.02; and the TACE+apatinib group had higher Half-year, one-year, and two-year survival rates; Adverse reactions in the apatinib combination group were significantly higher than those in the TACE group alone. The adverse reactions were mainly hypertension, fever, proteinuria, etc., improved after symptomatic treatment, with no other serious adverse reactions.Conclusion According to the analysis, the clinical efficacy and safety of apatinib combined with TACE in the treatment of advanced liver cancer are obvious.

Key words: Transcatheter hepatic arterial chemoembolization, Apatinib, Advanced liver cancer, Efficacy, Safety, Meta-analysis

段瑞芳, 杨道坤, 魏帅. TACE联合阿帕替尼治疗中晚期肝癌临床疗效与安全性的meta分析[J]. 肝脏, 2021, 26(1): 55-59.

DUAN Rui-fang, YANG Dao-kun, WEI shuai. Meta-analysis of clinical efficacy and safety of TACE combined with apatinib in the treatment of advanced liver cancer[J]. Chinese Hepatolgy, 2021, 26(1): 55-59.

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