AIM: To compare transcatheter arterial chemoembolization (TACE) and 3D conformal radiotherapy (3D-CRT) with TACE monotherapy in hepatocellular carcinoma (HCC). METHODS: We searched all the eligible studies from the Co...AIM: To compare transcatheter arterial chemoembolization (TACE) and 3D conformal radiotherapy (3D-CRT) with TACE monotherapy in hepatocellular carcinoma (HCC). METHODS: We searched all the eligible studies from the Cochrane Library, PubMed, Medline, Embase, and CNKI. The meta-analysis was performed to assess the survival benefit, tumor response, and the decline in alpha-fetoprotein (AFP) level. According to the heterogeneity of the studies, pooled OR with 95% CI were calculated using the fixed-effects or random-effects model. An observed OR > 1 indicated that the addition of 3D-CRT to TACE offered survival benefits to patients that could be considered statistically significant. Statistical analyses were performed using Review Manager Software. RESULTS: Ten studies met the criteria to perform a meta-analysis including 908 HCC participants, with 400 patients in the TACE/3D-CRT combination group and 508 in the TACE alone group. TACE combined with 3D-CRT significantly improved 1-, 2- and 3-year overall survival compared with TACE monotherapy (OR = 1.87, 95% CI: 1.37-2.55, P < 0.0001), (OR = 2.38, 95% CI: 1.78-3.17, P < 0.00001) and (OR = 2.97, 95% CI: 2.10-4.21, P < 0.00001). In addition, TACE plus 3DCRT was associated with a higher tumor response (complete remission and partial remission) (OR = 3.81; 95% CI: 2.70-5.37; P < 0.00001), and decline rates of AFP level (OR = 3.24, 95% CI: 2.09-5.02, P < 0.00001). CONCLUSION: This meta-analysis demonstrated that TACE combined with 3D-CRT was better than TACE monotherapy for patients with HCC, which needs to be confirmed by large multicenter trials. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.展开更多
目的：探讨异甘草酸镁对原发性肝癌肝动脉化疗栓塞术后肝脏的保护作用。方法选择原发性肝癌肝动脉化疗栓塞术患者68例作为研究对象，将其分为异甘草酸镁组和对照组，所有患者均在术前7 d到术后3 d 常规给予保肝药物治疗，异甘草酸镁组...目的：探讨异甘草酸镁对原发性肝癌肝动脉化疗栓塞术后肝脏的保护作用。方法选择原发性肝癌肝动脉化疗栓塞术患者68例作为研究对象，将其分为异甘草酸镁组和对照组，所有患者均在术前7 d到术后3 d 常规给予保肝药物治疗，异甘草酸镁组在保肝治疗的基础上给予异甘草酸镁治疗，检测并比较两组肝癌患者手术前后肝谷丙转氨酶、谷草转氨酶、总胆红素、总蛋白、白蛋白和胆碱酯酶水平。结果对照组术后3 d 的谷丙转氨酶、谷草转氨酶[（60．2±25．8）IU ／L、（71．5±29．6）IU ／L]均较术前升高[（34．7±18.6）IU ／L、（49．5±20．4）IU ／L]（t ＝7．264、5．974，均 P ＜0．05），异甘草酸镁组术后3 d 的肝损伤指标谷丙转氨酶、谷草转氨酶与术前差异无统计学意义（P ＞0．05）；异甘草酸镁组术前谷丙转氨酶、谷草转氨酶和总胆红素与对照组差异无统计学意义（P ＞0．05），异甘草酸镁组术后3 d 谷丙转氨酶、谷草转氨酶[（44．8±22．8）IU ／L、（57．3±24．8）IU ／L]均明显低于对照组[（60．2±25．8）IU ／L、（71．5±29．6）IU ／L]（t ＝6．385、7.358，均 P ＜0．05）。异甘草酸镁组和对照组术后3 d 的白蛋白和胆碱酯酶[（28．4±4．7）g／L、（8．0±4．8）kU ／L 比（29．3±3．5）g／L、（6．9±4．3）kU ／L]均较术前降低[（34．2±4．3）g／L、（9．3±5．4）kU ／L 比（33．7±3.9）g／L、（9．0±5．8）kU ／L]（t ＝11．834、6．247、10．276、8．743，均 P ＜0．05），异甘草酸镁组术前白蛋白和胆碱酯酶与对照组差异无统计学意义（P ＞0．05），异甘草酸镁组术后3 d 白蛋白和胆碱酯酶[（28．4±4．7）g／L、（8．0±4．8）kU ／L]均明显高于对照组[（29．3±3．5）g／L、（6．9±4．3）kU ／L]（t ＝8．436、6．947，均 P ＜0.05）。异甘草酸镁组不良反应发生率（上腹痛发生率为35．3％，发热发生率为29．4％，恶心呕吐发生率为52.9％）低于对照组（上腹痛发生率55．9％，发热发生率88．2％，恶心呕吐发生率为76．5％）（χ2＝7．246、6.472、6.274，均 P ＜0．05）。结论肝动脉化疗栓塞术对肝癌患者的肝功能有一定的损伤，异甘草酸镁可以减轻肝脏损害，提高肝脏合成功能，对肝脏有一定的保护作用。展开更多
文摘AIM: To compare transcatheter arterial chemoembolization (TACE) and 3D conformal radiotherapy (3D-CRT) with TACE monotherapy in hepatocellular carcinoma (HCC). METHODS: We searched all the eligible studies from the Cochrane Library, PubMed, Medline, Embase, and CNKI. The meta-analysis was performed to assess the survival benefit, tumor response, and the decline in alpha-fetoprotein (AFP) level. According to the heterogeneity of the studies, pooled OR with 95% CI were calculated using the fixed-effects or random-effects model. An observed OR > 1 indicated that the addition of 3D-CRT to TACE offered survival benefits to patients that could be considered statistically significant. Statistical analyses were performed using Review Manager Software. RESULTS: Ten studies met the criteria to perform a meta-analysis including 908 HCC participants, with 400 patients in the TACE/3D-CRT combination group and 508 in the TACE alone group. TACE combined with 3D-CRT significantly improved 1-, 2- and 3-year overall survival compared with TACE monotherapy (OR = 1.87, 95% CI: 1.37-2.55, P < 0.0001), (OR = 2.38, 95% CI: 1.78-3.17, P < 0.00001) and (OR = 2.97, 95% CI: 2.10-4.21, P < 0.00001). In addition, TACE plus 3DCRT was associated with a higher tumor response (complete remission and partial remission) (OR = 3.81; 95% CI: 2.70-5.37; P < 0.00001), and decline rates of AFP level (OR = 3.24, 95% CI: 2.09-5.02, P < 0.00001). CONCLUSION: This meta-analysis demonstrated that TACE combined with 3D-CRT was better than TACE monotherapy for patients with HCC, which needs to be confirmed by large multicenter trials. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
文摘目的：探讨异甘草酸镁对原发性肝癌肝动脉化疗栓塞术后肝脏的保护作用。方法选择原发性肝癌肝动脉化疗栓塞术患者68例作为研究对象，将其分为异甘草酸镁组和对照组，所有患者均在术前7 d到术后3 d 常规给予保肝药物治疗，异甘草酸镁组在保肝治疗的基础上给予异甘草酸镁治疗，检测并比较两组肝癌患者手术前后肝谷丙转氨酶、谷草转氨酶、总胆红素、总蛋白、白蛋白和胆碱酯酶水平。结果对照组术后3 d 的谷丙转氨酶、谷草转氨酶[（60．2±25．8）IU ／L、（71．5±29．6）IU ／L]均较术前升高[（34．7±18.6）IU ／L、（49．5±20．4）IU ／L]（t ＝7．264、5．974，均 P ＜0．05），异甘草酸镁组术后3 d 的肝损伤指标谷丙转氨酶、谷草转氨酶与术前差异无统计学意义（P ＞0．05）；异甘草酸镁组术前谷丙转氨酶、谷草转氨酶和总胆红素与对照组差异无统计学意义（P ＞0．05），异甘草酸镁组术后3 d 谷丙转氨酶、谷草转氨酶[（44．8±22．8）IU ／L、（57．3±24．8）IU ／L]均明显低于对照组[（60．2±25．8）IU ／L、（71．5±29．6）IU ／L]（t ＝6．385、7.358，均 P ＜0．05）。异甘草酸镁组和对照组术后3 d 的白蛋白和胆碱酯酶[（28．4±4．7）g／L、（8．0±4．8）kU ／L 比（29．3±3．5）g／L、（6．9±4．3）kU ／L]均较术前降低[（34．2±4．3）g／L、（9．3±5．4）kU ／L 比（33．7±3.9）g／L、（9．0±5．8）kU ／L]（t ＝11．834、6．247、10．276、8．743，均 P ＜0．05），异甘草酸镁组术前白蛋白和胆碱酯酶与对照组差异无统计学意义（P ＞0．05），异甘草酸镁组术后3 d 白蛋白和胆碱酯酶[（28．4±4．7）g／L、（8．0±4．8）kU ／L]均明显高于对照组[（29．3±3．5）g／L、（6．9±4．3）kU ／L]（t ＝8．436、6．947，均 P ＜0.05）。异甘草酸镁组不良反应发生率（上腹痛发生率为35．3％，发热发生率为29．4％，恶心呕吐发生率为52.9％）低于对照组（上腹痛发生率55．9％，发热发生率88．2％，恶心呕吐发生率为76．5％）（χ2＝7．246、6.472、6.274，均 P ＜0．05）。结论肝动脉化疗栓塞术对肝癌患者的肝功能有一定的损伤，异甘草酸镁可以减轻肝脏损害，提高肝脏合成功能，对肝脏有一定的保护作用。
