晚期肝细胞癌肝动脉灌注化疗与索拉非尼靶向治疗疗效比较的Meta分析

Meta analysis of hepatic arterial infusion chemotherapy versus sorafenib in the treatment of advanced hepatocellular carcinoma based on Asian patients

目的通过与索拉非尼(SORF)靶向治疗对比,评价肝动脉灌注化疗(HAIC)治疗晚期肝细胞癌(HCC)的疗效及安全性。方法使用计算机检索公开发表在PubMed、Springer Link、Cochrane、中国知网、万方、维普数据库,纳入符合要求的HAIC与SORF对比治疗晚期HCC的临床研究,采用Newcastle-Ottawa Scale(NOS)量表对文献质量进行评价,采用Cochrane协作网提供的RevMan 5.3软件对所纳入的研究进行Meta分析。结果最终有13项研究纳入分析,共包括晚期HCC患者1291例,Meta分析结果显示HAIC治疗晚期HCC的客观缓解率(ORR)和疾病控制率(DCR)均显著优于SORF(ORORR=4.00,95%CI:2.74~5.85,P<0.01;ORDCR=1.86,95%CI:1.46~2.36,P<0.01),总生存期(OS)和无进展生存时间(PFS)也优于SORF(MDOS=1.99,95%CI:0.69~3.30,P<0.01;MDPFS=1.17,95%CI:0.27~2.08,P<0.05),而疾病进展时间(TTP)两组比较差异无统计学意义(MD=1.65,95%CI:-1.66~4.96,P>0.05)。结论HAIC治疗晚期HCC疗效优于SORF,可提高晚期HCC患者的ORR和DCR,延长患者的OS和PFS。

Objective To evaluate the efficacy and safety of hepatic artery infusion chemotherapy(HAIC)in the treatment of advanced hepatocellular carcinoma(HCC)by comparing with sorafenib(SORF)targeted therapy.Methods Databases of Pu-bMed,Springer link,Cochrane,CNKI,Wanfang and VIP were searched;and the clinical trials of HAIC and SORF in the treatment of advanced HCC were retrieved.The quality of the studies was evaluated by NOS scale,and meta-analysis was conducted by Revman 5.3 software from Cochrane Collaboration network.Results Meta analysis showed that the objective response rate(ORR)and disease control rate(DCR)in HAIC group were significantly higher than those in SORF group(ORORR=4.00,95%CI:2.74-5.85,P<0.01.ORDCR=1.86,95%CI:1.46-2.36,P<0.01).The overall survival(OS)and progression free survival(PFS)of HAIC group were higher than those of SORF group(MDOS=1.99,95%CI:0.69-3.30,P<0.01.MDPFS=1.17,95%CI:0.27-2.08,P<0.05),but there was no significant difference in TTP between the two groups.Conclusion HAIC can improve the objective remission rate,disease control rate,prolong the overall survival and progression free survival,which is superior to SORF in the treatment of of patients with advanced HCC.