三维适形放疗联合TACE治疗肝癌并发门静脉癌栓疗效的Meta分析

Three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization for treatment of patients with hepatocellular carcinoma with portal vein tumor thrombus: A meta-analys

目的应用荟萃（Meta）分析法探讨三维适形放疗（3-DCRT）联合TACE与单纯TACE治疗肝癌伴门脉癌栓的近期及远期疗效。方法按系统评价原则,对2000年~2014年公开发表的有关3-DCRT联合TACE与单纯TACE治疗肝癌伴门脉癌栓的临床随机对照研究进行系统评价。结果共有8篇文献纳入研究,累计3D-CRT联合TACE治疗463例,单纯TACE治疗386例,纳入研究存在异质性,采用随机效应模型分析。Meta分析显示：3D-CRT联合TACE组与单纯TACE组在有效率[OR 2.871,95%CI（1.426,5.783）]、控制率[OR 2.871,95%CI（1.426,5.783）]、1 a生存率[OR 2.993,95%CI（1.713,5.230）]、2 a生存率[OR 3.054,95%CI（1.170,7.973）]均存在统计学差异（P〈0.05）。结论 3-DCRT联合TACE治疗肝癌伴门脉癌栓的近期及远期疗效优于单纯TACE治疗,值得进一步验证。

Objective To analyze the short and long-term effects of three-dimensional conformal radiation therapy（3D-CRT） combined with TACE versus TACE alone for treatment of patients with hepatocellular carcinoma with portal vein tumor thrombus（PVTT）. Methods Retrieval was performed according to the principles of systemic assessment,then we conducted a meta-analysis to compare 3-DCRT combined with TACE versus TACE alone for treatment of patients with hepatocellular carcinoma with PVTT. Results A total of 8 randomized controlled trials were included,and 463 cases receiving 3-DCRT combined with TACE and 386 receiving TACE alone were recruited. Compared with in TACE alone,the 3D-CRT combined with TACE treatment had advantages in tumour therapeutic response [OR 2.871,95%CI（1.426,5.783）,P〈0.05],control rate [OR 2.871,95%CI（1.426,5.783）,P〈0.05],1-year survival [OR 2.993,95%CI（1.713,5.230）,P〈0.05] and 2-year survival [OR 3.054,95%CI（1.170,7.973）,P〈0.05]. Conclusion 3D-CRT combined with TACE is better than TACE alone in treatment of patients with hepatocellular carcinoma with PVTT,which warrants further study.