经肝动脉化疗栓塞联合射频消融治疗原发性肝癌远期疗效的荟萃分析

Transcatheter arterial chemoembolization combined with radiofrequency ablation for the treatment of hepatocellular carcinoma: a meta-analysis of long-term efficacy

目的探讨经肝动脉化疗栓塞(TACE)联合射频消融(RFA)与单独行TACE治疗原发性肝癌的远期疗效的区别。方法检索CBM、CNKI、PubMed、EMBASE、ElsevierSciencedirect、Lippincott,Williams&Wilkins、Springer数据库,收集所有TACE联合RFA治疗原发性肝癌与单独性TACE治疗的临床随机对照试验(RCT)文献。按照纳入标准选择文献,提取相关数据,应用STATA11.0软件进行统计学处理。结果共纳入中外文献8篇,分别行亚组分析显示,TACE联合RFA治疗组的1、2、3年生存率均明显优于TACE单独治疗组[1年生存率:OR=0.49,95%CI(0.33,0.75),P=0.001;2年生存率:OR=0.40,95%CI(0.23,0.70),P=0.001;3年生存率:OR=0.50,95%CI(0.36,0.69),P=0.000]。结论与单独行TACE治疗相比,TACE联合RFA治疗方案能明显提高原发性肝癌患者的远期生存率。

Objective To compare the therapeutic effect of transcatheter arterial chemoembolization （TACE） plus radiofrequency ablation （RFA） with that of simple TACE for hepatocellular carcinoma （HCC）. Methods The data bases, including CBM, CNKI, PubMed, EMBASE, Elsevier Sciencedirect, Williams ＆ Wilkins, Lippincott and Springer, were searched. All data related to patients with HCC receiving TACE ＋ RFA or simple TACE in randomized-controlled clinical trials （RCT） were collected. Articles that met the inclusion criteria were reviewed systematically, and the reported data were aggregated using the statistical techniques of meta-analysis. Results A total of 8 articles were enrolled in this study. The subgroup analysis showed that the 1-year, 2-year and 3-year survival rates in TACE＋RFA group were statistically higher than those in simple TACE group [ 1-year survival rate： OR = 0.49, 95%CI （0.33,0.75）, P = 0.001 ; 2-year survival rate： OR = 0.40, 95%CI （0.23,0.70）, P = 0.001; 3-year survival rate： OR = 0.50, 95%CI （0.36,0.69）, P = 0.000]. Conclusion Compared with simple TACE, TACE plus RFA can significantly improve the long-term survival rate in patients with HCC.（J Intervent Radiol, 2013, 22： 387-391）