论文部分内容阅读
目的系统评价肝动脉化疗栓塞术(TACE)联合氩氦刀(AHCS)治疗原发性肝癌的疗效及安全性,为临床实践与研究提供参考。方法计算机检索e Cochrane Library、PubMed、EMbase、Web of Science、CBM、CNKI、VIP和WanFang Data等数据库,同时辅以其他检索,收集所有TACE联合氩氦刀治疗原发性肝癌的随机对照试验(RCT),检索时限均从建库至2012年5月1日。由2名评价员按照纳入标准筛选文献、提取资料和评价质量后,采用RevMan 5.1软件进行Meta分析。结果共纳入16个RCT,1 467例患者。Meta分析结果显示:①TACE+AHCS组的总有效率、完全坏死率、0.5年、1年、1.5年、2年、2.5年生存率、AFP、CD4和/Ts细胞方面均明显优于TACE组,两组差异均有统计学意义(P<0.05);②TACE+AHCS组的0.5年、1.5年、2年、2.5年生存率、AFP和细胞方面均优于AHCS组,两组差异均有统计学意义(P<0.05)。结论与单纯TACE或单纯AHCS治疗相比,TACE+AHCS治疗原发性肝癌能提高患者远期生存率和近期疗效,提高患者的免疫机能,但其长期疗效和安全性评价尚需更多大样本高质量的RCT进一步验证。
Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with cryoablation (AHCS) in the treatment of primary hepatocellular carcinoma (HCC) and provide a reference for clinical practice and research. Methods The databases of eCochrane Library, PubMed, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data were searched by computer. In addition, other randomized controlled trials (RCTs ), Search time from the database to May 1, 2012. Two reviewers screened the literature according to the inclusion criteria, extracted data and evaluated the quality, and then used RevMan 5.1 software to conduct meta-analysis. Results A total of 16 RCTs and 1 467 patients were enrolled. The results of Meta analysis showed that: ① The total effective rate, complete necrosis rate, 0.5 year, 1 year, 1.5 years, 2 years, 2.5 years survival rate, AFP, CD4 and / Ts cells in TACE + The difference between the two groups was statistically significant (P <0.05); ②TACE + AHCS group 0.5, 1.5, 2, 2.5 years survival rate, AFP and cells were better than the AHCS group, the two groups were statistically significant differences Significance (P <0.05). Conclusions TACE + AHCS treatment of primary hepatocellular carcinoma can improve the long-term survival and short-term curative effect and improve the immune function in patients with TACE alone or AHCS alone, but more long-term efficacy and safety evaluation are still needed High-quality RCT further validation.