肝癌伴门静脉癌栓内放疗治疗的临床荟萃分析

Clinical Meta-analysis of Intra-radiotherapy Treatment for Hepatocellular Carcinoma with Portal Vein Carcinoma Thrombosis

目的系统评价肝癌伴门静脉癌栓的内放疗(门静脉内植入125I放射性粒子)治疗的临床疗效。方法检索2010年1月—2022年1月期间内放疗治疗肝癌伴门静脉癌栓的临床对照研究文献。筛选文献、提取资料,应用RevMan5.4软件进行荟萃分析。结果包含1015例患者的12篇文献满足纳入要求,内放疗治疗组(观察组)527例,肝动脉栓塞化疗术治疗组(对照组)488例。荟萃分析结果表明,观察组的疾病控制率和缓解率均优于对照组,差异有统计学意义(P<0.05);两组术后1年、3年生存率比较,差异有统计学意义(P<0.05);观察组的中位生存期和平均寿命长于对照组,差异有统计学意义(P<0.05)。结论采取内放疗治疗肝癌伴门静脉癌栓能够取得较好的临床疗效,可以明显提高患者生存时间。

Objective To systematically evaluate the clinical efficacy of internal radiotherapy(intra-portal vein im⁃plantation of ^(125)I radioactive particles)for hepatocellular carcinoma with portal vein thrombosis.Methods The litera⁃tures of controlled clinical studies on radiotherapy for hepatoma with portal vein cancer thrombi during January 2010 to January 2022 were searched.Literature was screened,data were extracted,and meta-analysis was performed using RevMan5.4 software.Results Twelve literatures including 1015 patients met the inclusion requirements,including 527 patients in the internal radiotherapy group(observation group)and 488 patients in the hepatic arterial emboliza⁃tion group(control group).The results of meta-analysis showed that the disease control rate and remission rate in the observation group were better than those in the control group,and the difference was statistically significant(P<0.05).Comparison of 1-year and 3-year postoperative survival rates between the two groups,and the difference was statisti⁃cally significant(P<0.05).The median survival time and average life span of the observation group were longer than those of the control group,and the difference was statistically significant(P<0.05).Conclusion The treatment of hepa⁃tocellular carcinoma with portal vein thrombosis by internal radiotherapy can achieve better clinical efficacy and can significantly improve the survival time of patients.