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目的评价肝动脉化疗栓塞(TACE)联合门静脉化疗(PVC)对手术或非手术肝癌患者的疗效。方法通过计算机检索Pub Med、EMBASE、Cochrane Library(CENTRAL)databases、Web of Science、Sciencedirect、National Institute of Health Clinical Trials Database、中国知网、万方数据库和维普网获取相关文献。使用Revman 5.1软件进行统计分析。结果通过检索及筛选,共有10篇相关文献符合纳入标准。其中术后组6篇,未手术组4篇。所有亚组分析各组间异质性均无统计学意义。统计学分析均显示TACE+PVC可明显改善患者1年和2/3年总体生存率和无瘤生存率。术后组:1年无瘤生存率OR=2.09,95%CI=1.21~3.61;3年无瘤生存率OR=3.62,95%CI=1.88~6.97;1年总生存率总OR=2.25,95%CI=1.30~3.87;3年总生存率OR=1.96,95%CI=1.20~3.21。未手术组:1年总生存率OR=3.90,95%CI=2.33~6.54;2年总生存率OR=5.30,95%CI=1.87~15.06。结论术后辅助TACE联合PVC治疗较单纯辅助TACE治疗可显著改善肝癌患者1年及3年无瘤生存率和总生存率。而对于无手术指征的患者,TACE联合PVC可明显改善患者的1年及2年总生存率。但由于本文纳入高质量文献较少,临床医师在参考本文进行临床决策时应谨慎。
Objective To evaluate the efficacy of transcatheter hepatic arterial chemoembolization (TACE) in combination with portal vein chemotherapy (PVC) for patients with surgical or non-surgical liver cancer. Methods PubMed, EMBASE, Cochrane Library (CENTRAL) databases, Web of Science, Sciencedirect, National Institute of Health Clinical Trials Database, CNKI, Wanfang Database and WEP were searched by computer. Use Revman 5.1 software for statistical analysis. Results After searching and screening, a total of 10 related articles met the inclusion criteria. Among them, 6 were postoperative and 4 were nonoperative. Heterogeneity was not statistically significant among all subgroups in all groups. Statistical analysis showed that TACE + PVC can significantly improve the 1-year and 2/3-year overall survival and tumor-free survival rate. In the postoperative group, the 1-year disease-free survival rate was 2.09 and 95% CI was 1.21 to 3.61. The 3-year disease-free survival rate was 3.62 and 95% CI was 1.88 to 6.97. The overall 1-year overall survival rate was OR = 2.25, 95% CI = 1.30 ~ 3.87; 3-year overall survival OR = 1.96, 95% CI = 1.20 ~ 3.21. One-year overall survival was OR = 3.90, 95% CI = 2.33 ~ 6.54 in the non-operation group. The 2-year overall survival was OR = 5.30, 95% CI = 1.87 ~ 15.06. Conclusions Postoperative adjuvant TACE with PVC can significantly improve the 1-year and 3-year disease-free survival and overall survival of patients with hepatocellular carcinoma compared with simple adjuvant TACE. For patients without surgical indications, TACE combined with PVC can significantly improve the patient’s 1-year and 2-year overall survival. However, due to the high quality literature included in this article, clinicians should be cautious when making clinical decisions with reference to this article.