TACE联合疗法与单独行TACE治疗肝细胞癌生存率差异的Meta分析

Transcatheter Arterial Chemoembolization Combination Therapy vs Transcatheter Arterial Chemoembolization for the Treatment of Unresectable Hepatocellular Carcinoma:A Meta-Analysis of Survival Rate

目的综合分析肝动脉化疗栓塞（TACE）联合射频消融（RFA）或经皮无水乙醇注射（PEI）或高强度聚焦超声（HIFU）与单独行TACE治疗不可手术切除的肝细胞癌（HCC）生存率的差异,为HCC的治疗提供理论依据。方法系统搜集比较TACE联合疗法与单独行TACE治疗不可手术切除的HCC患者生存率差异的回顾性队列研究,从中提取相关数据,按照NOS量表对纳入文献进行质量评价。结果共纳入16篇回顾性队列研究,1856例患者。Meta分析显示,TACE联合治疗组1年、2年、3年生存率均优于TACE单独治疗组[1年生存率：OR=2.978,95%CI（2.328,3.809）,P〈0.001;2年生存率：OR=2.656,95%CI（1.982,3.558）,P〈0.001;3年生存率：OR=3.078,95%CI（2.420,3.914）,P〈0.001]。敏感性分析揭示两组生存率的差异结果可靠。结论与单独行TACE相比,TACE联合治疗组的患者1年、2年、3年生存率均较高。

Objective To investigate the difference of long-term survival rate of transcatheter arterial chemoembolization（ TACE） combined with radiofrequency ablation（ RFA） or percutaneous ethanol injection（ PEI） or high intensity focused ultrasound（ HIFU） with TACE alone for the treatment of unresectable hepatocellular carcinoma（ HCC） and to provide the basis for the treatment of HCC. Methods Searching for the retrospective cohort studies with regards to comparing the difference of long-term survival rate between TACE combination therapy and TACE alone for the treatment of unresectable HCC. Relevant data were extracted accordingly. The quality of selected studies was evaluated according to the NOS scale.Results A total of 16 studies were selected,including 1856 HCC patients. Results of meta-analysis showed that the 1-year,2-year and 3-year survival rate of TACE combination therapy were significantly greater than TACE alone（ 1-year survival rate： OR = 2.978,95% CI（ 2.328,3.809）,P〈0.001; 2-year survival rate： OR = 2. 656,95% CI（ 1.982,3.558）,P 0.001; 3-year survival rate： OR = 3.078,95% CI（ 2.420,3.914）,P〈0.001）. The sensitivity analysis indicated that the Results were reliable. Conclusion Compare to TACE alone,the 1-year,2-year and 3-year survival rate of patients treated with TACE combination therapy is higher.