肝动脉化疗栓塞术联合复方斑蝥治疗中晚期原发性肝癌疗效和安全性的Meta分析

Safety and efficacy of transcatheter arterial chemoembolization combined with Fufangbanmao for the treatment of advanced primary liver cancer:a meta-analysis

目的探讨肝动脉化疗栓塞(TACE)联合复方斑蝥与单纯TACE治疗中晚期原发性肝癌(APLC)的有效性和安全性。方法检索《万方》、《知网》、《维普》、医学文献检索等中外文数据库从建库至2016年12月前发表的采用TACE联合复方斑蝥方案治疗APLC的随机对照研究(RCT),提取数据评价研究质量,并纳入Meta分析(Rev Man5.3)。结果共纳入8篇相关文献,共含720例APLC患者(联合组369例,TACE组351例)。结果表明与TACE相比,联合组能够提高APLC患者的近期有效率(OR=1.53,95%CI:1.13~2.08)和生活质量(OR=2.47,95%CI:1.61~3.79);且能减缓疾病进展率(OR=0.27,95%CI:0.19~0.42)和减少骨髓抑制的发生率(OR=0.27,95%CI:0.19~0.42)。结论 TACE联合复方斑蝥方案对APLC患者治疗的有效性和安全性优于单纯TACE治疗。

Objective To evaluate the safety and the efficacy of trancatheter arterial chemoembolization（TACE） combined with Fufangbanmao compared with TACE alone for the treatment of advanced primary liver cancer（APLC） by meta-analysis. Methods The randomized controlled trials associated with the combination-treatment of Fufangbanmiao and TACE for APLC from the building of each database to December 2016 were searched and analyzed from Wangfang, CNKI, VIP and Pubmed databases. After the qualities of the included studies were assessed, meta-analyses were conducted by Rev Man5.3 statistical software. Results Eight eligible trials were included, and a total of 720 cases（369 cases from Fufangbanmiao combined with TACE treatment group and 351 cases from TACE alone treatment group） were assessed in this meta-analysis. The results showed that the combination-treatment, compared with TACE alone, could increase the effective rate（OR=1.53, 95% CI： 1.13-2.08）, improve the life quality（OR=2.47, 95%CI： 1.61-3.79）, decrease disease progression rate（OR=0.27, 95% CI： 0.19-0.42）, and decreased the incident for bone marrow suppression（OR=0.27, 95%CI： 0.18-0.40） for patients. Conclusion Meta-analysis indicates that the safety and efficacy of the Fufangbanmiao combined with TACE is superior to TACE alone in the treatment of APLC.