放射治疗联合肝动脉化疗栓塞与单纯肝动脉化疗栓塞治疗原发性肝癌的荟萃分析

Radiotherapy combined with transcatheter arterial chemoembolization versus transcatheter arterial chemoembolization alone for primary hepatic carcinoma:A meta-analysis

目的运用循证医学的方法,对放射治疗(radiotherapy,RT)联合肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)治疗原发性肝癌与单纯TACE治疗的远期疗效进行系统评价。方法通过计算机和手工检索,收集国内符合条件的临床对照研究文献,应用Jadad评分法进行质量评价,并用RevMan4.2软件进行Meta分析。结果 RT+TACE与单纯TACE相比,1年生存率RR=1.55,95%CI为[1.39,1.74],P<0.000 01;2年生存率RR=1.87,95%CI为[1.52,2.29],P<0.000 01;3年生存率RR=2.05,95%CI为[1.57,2.67],P<0.000 01,差异有显著性。结论 RT联合TACE治疗原发性肝癌的远期疗效较单纯TACE治疗好,能够提高患者生存率。

Objective To evaluate the efficacy of transcatheter arterial chemoembolization（TACE） combined with or without Radiotherapy（RT） in treating primary hepatic carcinoma with evidence based medicine method.Methods Data of patients with PHC undergoing RT＋TACE versus TACE were collected from literature by electronic searching and handwork searching.Meta analysis was conducted on the selected reports by means of Review Manager 4.2.The quality of reports of randomized clinical trials were evaluated according to the method given by Jadad.Results Compared with TACE alone,the result of survival rate that group undergoing RT＋TACE was statistically higher（1-year survival RR=1.55,95%CI,1.39~1.74,P0.000 01;2-year survival RR=1.87,95%CI,1.52~2.29,P0.000 01;3-year survival RR=2.05,95%CI,1.57~2.67,P0.000 01）.Conclusion Considering the long-term curative effect,to treat primary liver cancer by TACE in combination with RT is better than using TACE alone,which can improve the survival of the patients.