CalliSpheres载药微球与传统经肝动脉化疗栓塞术治疗肝细胞癌效果和安全性比较的Meta分析

Efficacy and safety of CalliSpheres microsphere versus conventional transcatheter arterial chemoembolization in treatment of hepatocellular carcinoma:A Meta-analysis

目的本研究旨在通过Meta分析比较CalliSpheres载药微球经肝动脉化疗栓塞术(CSM-TACE)与传统经肝动脉化疗栓塞术(cTACE)治疗肝细胞癌的有效性和安全性。方法系统的检索PubMed、Web Science、Cochrane Library、中国知网数据库、万方数据库和维普数据库,比较CSM-TACE与cTACE在肝细胞癌中应用的所有中英文文献,截止日期到2020年10月。对纳入文献进行质量学评价后,采用Cochrane Library提供的RevMan 5.3软件进行分析。结果经筛选后共纳入15篇研究,包括1535例患者。Meta分析显示,接受CSM-TACE治疗的患者1年总生存率(OR=2.26,95%CI:1.63~3.13,P<0.00001)、2年总生存率(OR=1.73,95%CI:1.20~2.50,P=0.003)和2年无进展生存率(OR=1.60,95%CI:1.05~2.43,P=0.03)显著高于接受cTACE治疗的患者。而且在安全性方面,接受CSM-TACE治疗的患者术后呕吐率(OR=0.65,95%CI:0.46~0.92,P=0.01)、骨髓抑制率(OR=0.17,95%CI:0.05~0.54,P=0.003)、粒细胞减少率(OR=0.18,95%CI:0.07~0.45,P=0.0003)均明显低于接受cTACE治疗的患者,在术后发热率、腹痛率、腹水率方面两组差异均无统计学意义(P值均>0.05)。结论CSM-TACE在提高1年和2年总生存率以及2年无进展生存率方面具有显著优势,而且可明显降低患者术后呕吐率、骨髓抑制率、粒细胞减少率。因此,CSM-TACE是一种安全、有效的治疗方式。

Objective To investigate the efficacy and safety of CalliSpheres microsphere-transcatheter arterial chemoembolization(CSM-TACE)versus conventional transcatheter arterial chemoembolization(cTACE)in the treatment of hepatocellular carcinoma(HCC)through a meta-analysis.Methods PubMed,Web of Science,Cochrane Library,CNKI,Wanfang Data,and VIP were searched for all Chinese and English articles on the application of CSM-TACE and cTACE in HCC published up to the end of October,2020.After quality assessment was performed for the articles included,RevMan 5.3 software provided by Cochrane Library was used for analysis.Results A total of 15 studies were included,with 1535 patients in total.This meta-analysis showed that compared with the patients receiving cTACE,the patients receiving CSM-TACE had significantly higher 1-year overall survival rate(odds ratio[OR]=2.26,95%confidence interval[CI]:1.63-3.13,P<0.00001),2-year overall survival rate(OR=1.73,95%CI:1.20-2.50,P=0.003),and 2-year progression-free survival rate(OR=1.60,95%CI:1.05-2.43,P=0.03).In terms of safety,compared with the patients receiving cTACE,the patients receiving CSM-TACE had significantly lower incidence rates of postoperative vomiting(OR=0.65,95%CI:0.46-0.92,P=0.01),bone marrow suppression(OR=0.17,95%CI:0.05-0.54,P=0.003),and neutropenia(OR=0.18,95%CI:0.07-0.45,P=0.0003),while there were no significant differences between the two groups of patients in postoperative pyrexia,abdominal pain,and ascites(all P>0.05).Conclusion CSM-TACE has significant advantages in improving 1-and 2-year overall survival rates and 2-year progression-free survival rates and can significantly reduce the incidence rates of postoperative vomiting,bone marrow suppression,and neutropenia.Therefore,CSM-TACE is a safe and effective treatment method.