摘要
目的 评价经导管动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)+仑伐替尼(lenvatinib,LEN)治疗中晚期原发性肝癌的有效性与安全性。方法 在中国知网、维普、Ovid、Scopus、PubMed等数据库中全面检索相关文献,检索时间为建库至2023年3月14日,根据检索策略和纳入与排除标准获取文献,并提取数据和进行文献质量评价,采用RevMan 5.4软件和Stata 15.1软件进行meta分析评价TACE+LEN治疗对原发性肝癌患者主要结局指标客观缓解率、疾病控制率、总生存期以及次要结局指标天冬氨酸转氨酶、丙氨酸转氨酶、甲胎蛋白、高血压、腹泻、手足病、疲劳、蛋白尿及发热的影响。结果 共纳入15篇文献共1 219例原发性肝癌患者,TACE+LEN治疗者591例,单用TACE治疗者628例。meta分析结果显示,TACE+LEN治疗相较于单用TACE治疗可提高客观缓解率、疾病控制率和延长总生存期(P<0.01),且能有效降低甲胎蛋白水平(P<0.01),但TACE+LEN治疗相较于单用TACE治疗后发生高血压、腹泻、手足病、疲劳和蛋白尿的风险会增高(P<0.05),但对肝功能指标天冬氨酸转氨酶、丙氨酸转氨酶和发热并发症发生风险未见明显影响(P>0.05)。结论 从本meta分析结果看,TACE+LEN治疗中晚期原发性肝癌有效,但也应重视其相关并发症的预防。
Objective To evaluate systematically the effectiveness and safety of transcatheter arterial chemoembolization(TACE)in combination with lenvatinib(LEN)in the treatment of intermediate and advanced primary liver cancer(PLC).Methods The relevant literature was comprehensively searched in the CNKI,VIP,Ovid,Schopus,PubMed,and other databases from the establishment of the databases to March 14,2023.The literature was obtained according to the search strategy and the inclusion and exclusion criteria,and the data were extracted and the literature quality was evaluated.The Revman 5.4 software and Stata 15.1 software were used to conduct the meta-analysis to evaluate the effect of TACE+LEN regimen on the objective response rate(ORR),disease control rate(DCR),overall survival(OS),as well as secondary outcome indicators such as aspartate aminotransferase(AST),alanine aminotransferase(ALT),alpha fetoprotein(AFP),and hypertension,diarrhea,hand-foot disease,fatigue,proteinuria,and fever for the patients with PLC.ResultsA total of 15 relevant literature was included,including 1219 patients with PLC,591 of whom treated with TACE+LEN and 628 treated with TACE alone.The meta-analysis results showed that the TACE+LEN regimen could increase ORR and DCR and prolong OS(P<0.01),as well as effectively decrease AFP level(P<0.01).However,TACE+LEN regimen increased the risks of hypertension,diarrhea,hand-foot disease,fatigue,and proteinuria as compared with TACE alone treatment(P<0.05).However,there were no statistical impacts on AST and ALT,or the risk of fever(P>0.05).Conclusion From the results of this meta-analysis,TACE+LEN regimen has a certain efficacy in treatment of intermediate and advanced PLC,but prevention of its related complications is paid attention to.
作者
王保江
丛鹏
WANG Baojiang;CONG Peng(Division of Hepatobiliary Surgery,Nanchong Central Hospital,Second Clinical Medical CollegeofNorth Sichuan Medical,Nancho Sichuan 637000,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2023年第12期1444-1451,共8页
Chinese Journal of Bases and Clinics In General Surgery
基金
四川省医学科研课题计划(项目编号:S21085)。
