恩度联合TACE治疗中晚期肝癌疗效及安全性的Meta分析

目的:对恩度联合TACE治疗中晚期肝癌的疗效及安全性进行评价.方法:计算机检索Cochrane Library、PubMed、中国知网、维普、中国生物医学文献数据库、万方数据库,收集所有关于恩度联合TACE治疗中晚期肝癌的RCT试验.对文献质量进行严格评价和资料提取,并对符合标准的文献进行Meta分析.结果:共20篇文献累计病例1 145例纳入本研究.Meta分析结果显示,恩度联合TACE 组客观有效率OR=2.96,95%CI(2.26,3.86),P<0.000 01]、1年生存率OR=2.56,95%CI(1.61,4.08),P<0.000 1]、肝外转移发生率OR=0.28,95%CI(0.17,0.46),P<0.000 01]、MVD(平均微血管密度)MD=-18.54,95%CI(-24.90,-12.18),P<0.000 01]、KPS评分MD=5.48,95%CI(2.66,8.31),P=0.000 1]均优于TACE组,而两组在不良反应上的差异无统计学意义.结论:恩度联合TACE治疗中晚期肝癌的有效性优于TACE单独疗法,而安全性无明显差异.

A Meta-analysis of the combination of Endostar and transarterial chemoembolization for treatment of advanced liver cancer

Objective:To study the effectiveness of the combination of Endostar and transcatheter arterial chemoembolization(TACE)for treatment of advanced primary liver cancer.Methods:The relevant studies from the establishment time of the databases to February 2015 were retrieved from the databases of PubMed,Cochrane Library,CNKI,CBM,VIP.Results:There were totally 20 RCT (1 145 patients) included.Meta-analysis showed:Tumor response rateOR=2.96,95%CI(2.26,3.86),P<0.000 01],1-year survival rateOR=2.56,95%CI(1.61,4.08),P<0.000 1],extrahepatic metastasisOR=0.28,95%CI(0.17,0.46),P<0.000 01],MVDMD=-18.54,95%CI(-24.90,-12.18),P<0.000 01],KPSMD=5.48,95%CI(2.66,8.31),P=0.000 1]of the combination of Endostar and TACE were much better than that of TACE,although there was no significant difference in safety between the two groups.Conclusion:The combination of Endostar and TACE has more advantages in terms of safety and efficacy in the treatment of advanced liver cancer than that of TACE mono-therapy.