TACE联合RFA与单纯RFA治疗肝细胞癌疗效与安全性比较的Meta分析

目的采用Meta分析评价TACE联合射频消融(RFA)与单纯RFA治疗肝细胞癌(HCC)的疗效及安全性。方法检索2000年1月—2016年11月关于TACE联合RFA与单纯RFA治疗HCC的临床随机对照试验设计的中英文文献,提取纳入研究的信息并行Meta分析。结果共12篇文献入选本研究。Meta分析结果显示,TACE联合RFA组1年、3年总体生存率及1年、3年无瘤生存率均优于单纯RFA治疗组,差异有统计学意义(P均0.05);两组间5年总体生存率差异无统计学意义(P=0.07)。对于肿瘤最大径3cm的HCC,TACE联合RFA组与单纯RFA组1年、3年总体生存率及1年、3年无瘤生存率差异均无统计学意义(P均0.05)。两组间严重并发症发生率差异无统计学意义(P=0.82)。结论 TACE联合RFA治疗HCC的近、中期疗效优于单纯RFA治疗,远期疗效无明显差异。

Efficacy and safety of radiofrequency ablation combined with or without TACE for hepatocellular carcinomas:Meta-analysis

Objective To investigate the effectiveness and safety of TACE combined with radiofrequency ablation (RFA) and simple RFA in the treatment of hepatocellular carcinoma (HCC) with Meta-analysis. Methods The randomized controlled trials comparing of TACE combined with RFA and simple RFA in the treatment of HCC from January 2000 to November 2016 in Chinese and English literatures were included. Results A total of 12 articles were enrolled in this study. Meta-analyses showed that the 1-year, 3-year overall survival rate and 1-year, 3-year recurrence-free survival rate of TACE combined with RFA group were better than those of simple RFA group (all P <0.05). And there was no significant difference between TACE combined with RFA group and simple RFA group in 5-year overall survival rate (P=0.07). There was no significant difference of the 1-year, 3-year overall survival and 1-year and 3-year recurrence-free survival rate between TACE combined with RFA group and simple RFA group for tumor with maximum diameter <3 cm in HCC (all P >0.05). There was no significant difference in the incidence of serious complication in both two groups (P=0.82). Conclusion The short-term and mid-term efficacy in the treatment of HCC using TACE combined with RFA is better than those using simple RFA, while the long-term efficacy of two kinds of therapy have no significant differences.