重组人血管内皮抑素注射液联合经肝动脉化疗栓塞治疗原发性肝癌的Meta分析

Intrahepatic arterial infusion of endostatin combined with transcatheter arterial chemoembolization for treatment of advanced hepatocellular carcinoma: A meta-analysis

目的:评价重组人血管内皮抑素注射液(恩度)联合肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)治疗中晚期原发性肝癌的疗效和安全性.方法:通过计算机全面检索PubMed、Cochrane Library、中国知网、万方、维普数据库中恩度联合TACE治疗原发性肝癌的随机对照试验,检索时间为建库至2014-10,并手工检索相关期刊与会议论文.按照纳入与排除标准选择试验、评价质量和提取有效数据,而后采用Rev Man5.2软件进行Meta分析.结果:纳入17项随机对照试验(randomized controlled trials,RCT),共计907例.结果显示,恩度联合TACE在治疗后总有效率、降低术后3、7和28 d肝癌组织中血管内皮生长因子(vascular endothelial growth factor,VEGF)的水平、1年生存率方面均优于单纯使用TACE.二者安全性差异无统计学意义.结论:恩度联合TACE治疗中晚期原发性肝癌是优效的.由于纳入的文献质量评分不高,上述结论仍需要大样本临床随机对照试验进行验证.

AIM： To evaluate the efficacy and safety of endostatin combined with transcatheter arterial chemoem bolization（ TACE） for advanced primary liver cancer. METHODS： Pub Med, Cochrane Library, China National Knowledge（CNKI）, China Scientific Journal Database by VIP, and Wan Fang Data were searched from inception to October 2014 to retrieve relevant studies. According to the inclusion criteria, the studies were included. Meta-analysis was performed using Rev Man5.2 software. RESULTS： Seventeen randomized controlled trials（RCTs）, involving a total of 907 patients, were eligible for the study. Meta-analysis showed that endostat in combinedwith TACE was superior to TACE alone in terms of tumor response rate, vascular endothelial growth factor（VEGF） expression and 1-year survival rate, although there was no significant difference in safety between the two groups. CONCLUSION： Endostatin combined with TACE can improve the survival of patients with advanced primaryliverc ancer and prevent tumor progression with acceptable toxicities.