摘要
目的对比肝动脉化疗栓塞(TACE)联合微波消融(MWA)与单独MWA治疗≤5 cm肝癌的临床疗效。方法计算机辅以人工检索国内外关于TACE+MWA与单独MWA治疗≤5 cm肝癌效果对比的临床对照试验。纳入分析患者生存率和肿瘤复发及并发症。视情况使用固定或随机效应模型计算二分类变量的Meta结果,包括合并的比值比(OR)值及其95%置信区间(CI)。结果符合条件的5篇文献268例患者纳入分析,148例接受TACE+MWA治疗,120例接受单独MWA治疗。Meta分析结果显示:TACE+MWA组1、2年生存率优于单独MWA组(OR1-year=2.65,95%CI:1.26~5.56,P=0.01;OR2-year=2.16,95%CI:1.16~4.02,P=0.02),1年复发率低于单独MWA组(OR1-year=0.43,95%CI:0.21~0.86,P=0.02),差异均有统计学意义。TACE+MWA组3年生存率(OR3-year=1.64,95%CI:0.81~3.31,P=0.17)及2、3年复发率(OR2-year=0.36,95%CI:0.11~1.13,P=0.08;OR3-year=0.75,95%CI:0.38~1.47,P=0.40)和单独MWA组相较差异无统计学意义。结论 TACE+MWA对于≤5 cm肝癌的治疗近期效果优于单独MWA治疗,远期疗效尚无优势。
Objective To compare transarterial chemoembolization（ TACE） and microwave ablation（ MWA） with MWA monotherapy for liver cancer less than 5 cm. Methods A computer-based search and manual searching was per-formed. The overall survival rate,tumor recurrence,and safety were analyzed and compared. The analysis was conducted on dichotomous outcomes and the standard meta-analytical techniques were used. Pooled odds ratios（ ORs） with 95% CIs were calculated using either the fixed-effects or random-effects model. Results Five studies were identified as eligible for inclusion in this analysis and included 268 patients with 148 treated with TACE ＋ MWA and 120 with MWA alone. Our data analysis indicated that TACE ＋ MWA was associated with a significantly higher 1 and 2 year overall survival rates（ OR1-year = 2. 65,95% CI： 1. 26-5. 56,P = 0. 01; OR2-year = 2. 16,95% CI： 1. 16-4. 02,P = 0. 02） and lower 1 year recurrence rate（ OR1-year = 0. 43,95% CI： 0. 21-0. 86,P = 0. 02） vs that of MWA alone. However,there was no significant difference between TACE ＋ MWA and MWA on 3 year overall survival rate（ OR3-year = 1. 64,95% CI： 0. 81-3. 31,P = 0. 17）. Besides,the 2 and 3 year recurrence rates（ OR2-year = 0. 36,95% CI： 0. 11-1. 13,P = 0. 08;OR3-year = 0. 75,95% CI： 0. 38-1. 47,P = 0. 40） in TACE ＋ MWA group were not significantly lower than that of simple MWA group. Conclusion The combination of MWA with TACE has advantages in improving short-term clinical results for liver cancer less than 5 cm and no significant benefit has been found for long-term prognosis.
出处
《临床放射学杂志》
CSCD
北大核心
2017年第6期875-879,共5页
Journal of Clinical Radiology
