恩度联合TACE治疗中晚期肝癌疗效及安全性的Meta分析

A Meta-analysis of the combination of Endostar and transarterial chemoembolization for treatment of advanced liver cancer

目的:对恩度联合TACE治疗中晚期肝癌的疗效及安全性进行评价。方法:计算机检索Cochrane Library、PubMed、中国知网、维普、中国生物医学文献数据库、万方数据库,收集所有关于恩度联合TACE治疗中晚期肝癌的RCT试验。对文献质量进行严格评价和资料提取,并对符合标准的文献进行Meta分析。结果:共20篇文献累计病例1 145例纳入本研究。Meta分析结果显示,恩度联合TACE组客观有效率[OR=2.96,95%CI(2.26,3.86),P<0.000 01]、1年生存率[OR=2.56,95%CI(1.61,4.08),P<0.000 1]、肝外转移发生率[OR=0.28,95%CI(0.17,0.46),P<0.000 01]、MVD(平均微血管密度)[MD=-18.54,95%CI(-24.90,-12.18),P<0.000 01]、KPS评分[MD=5.48,95%CI(2.66,8.31),P=0.000 1]均优于TACE组,而两组在不良反应上的差异无统计学意义。结论:恩度联合TACE治疗中晚期肝癌的有效性优于TACE单独疗法,而安全性无明显差异。

Objective：To study the effectiveness of the combination of Endostar and transcatheter arterial chemo- embolization（TACE）for treatment of advanced primary liver cancer. Methods： The relevant studies from the establish-ment time of the databases to February 2015 were retrieved from the databases of PubMed,Cochrane Library,CNKI,CBM,VIP. Results： There were total ly 20 RCT （ 1 145 patients） included. Meta - analysis showed：Tumor response rate[OR =2.96 ,95% Cl（2. 26,3. 86） 〈0. 000 01 ] ,1 - year survival rate[OR = 2. 56,95% CI（ 1.61,4.08 ） ,P 〈0. 0001] , extrahepatic metastasis[OR = 0. 28 ,95% CI（ 0.17,0.46 ） ,P 〈0 .00001 ],MVD [MD = - 18. 54 ,9 5% Cl （-24.90, -12.18） ,P 〈0.000 01] ,KPS[MD =5. 48,95% CI （2. 66,8.31）,P = 0. 0001] of the combination of Endostar and TACE were much better than that of TACE, although there was no significant difference in safety be-tween the two groups. Conclusion ： The combination of Endostar and TACE has more advantages in terms of safety and efficacy in the treatment of advanced liver cancer than that of TACE mono - therapy.