利卡汀联合肝动脉栓塞化疗治疗中晚期肝癌的效果及安全性的系统评价

Efficacy and safety of licartin combined with TACE for the treatment of advanced liver cancer

目的评价利卡汀(^(131)I美妥昔单抗)联合肝动脉栓塞化疗(TACE)治疗中晚期肝癌的效果与安全性。方法计算机检索Medline、Cochrane、Embase、SCI、CNKI、万方数据库(截至2016年3月)。收集比较利卡汀联合TACE与单纯TACE的临床对照试验。采用Rev Man 5.2统计分析软件对所有收集数据进行统计分析。结果共纳入8篇文献,其中2篇随机对照试验,6篇非随机对照试验,共967例患者。分析结果显示,联合组的近期有效率(OR=3.07,95%CI[2.06,4.58])、半年生存率(OR=1.46,95%CI[1.25,1.70])、一年生存率(OR=1.91,95%CI[1.41,2.57])、两年生存率(OR=2.19,95%CI[1.20,3.99])、疾病进展时间(MD=2.13,95%CI[1.88,2.38])与对照组比较,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,恶心呕吐(OR=1.48,95%CI[1.09,2.01])、白细胞减少(OR=2.53,95%CI[1.84,3.47])、血小板减少(OR=2.12,95%CI[1.55,2.88])、ALT(OR=1.59,95%CI[1.11,2.30])及胆红素(OR=1.76,95%CI[1.28,2.44])比较,差异有统计学意义(P<0.05),而发热、腹痛、AST、白蛋白比较,差异无统计学意义(P>0.05)。结论利卡汀联合TACE对于中晚期肝癌患者而言是一种安全且更有效的治疗手段,但仍需密切观察,积极预防处理不良反应。

Objective To evaluate the efficacy and safety of licartin （^131I-metuximab） combined with TACE for the treatment of advanced liver cancer. Methods Medline, Coehrane, Embase, SCI, CNKI and Wanfang Datebase were searched about clinical controlled trials of licartin combined with TACE for advanced liver cancer. All the data were analyzed with RevMan 5.2 software. Results Eight trials with 967 patients were in accordance with the inclusive criteria. There were two papers randomized controlled trials and other six papers were non-randomized controlled trials. Compared with the control group, the union group had higher effective rate （RR） （OR=3.07, 95%C112.06, 4.58]）, half a year survival time （OR=1.46, 95%CI[1.25, 1.70]）, one year survival time （OR=1.91, 95%CI[1.41, 2.57]）, two years survival time（OR=2.19, 95%C/[1.20, 3.99]） and time to progress （TFP） （MD=2.13, 95%C/[1.88, 2.38]）, and all the dif- ference was significant. However, the adverse reaction, including nausea and vomiting （0R=1.48, 95%C/ [1.09, 2.01]）, leucopenia （OR=2.53, 95%C1[1.84, 3.47]）, thrombocytopenia （OR=2.12, 95%CI[1.55, 2.88]）, ALT（OR= 1.59, 95%C/ [1.1 l, 2.30]） and bilirubin （OR=1.76, 95%CI[1.28, 2.44]）, with significant difference between the two groups （P 〈 0.05）. But the difference of fever, abdominal pain, AST and albumin had no statistical significance （P 〉 0.05）. Conclusion Compared with TACE alone, the licartin combined with TACE is a safe and effective treatment for advanced liver cancer. But the adverse reactions are also needed to observe closely and deal with actively.