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目的采用Meta分析评价TACE联合射频消融(RFA)与单纯RFA治疗肝细胞癌(HCC)的疗效及安全性。方法检索2000年1月—2016年11月关于TACE联合RFA与单纯RFA治疗HCC的临床随机对照试验设计的中英文文献,提取纳入研究的信息并行Meta分析。结果共12篇文献入选本研究。Meta分析结果显示,TACE联合RFA组1年、3年总体生存率及1年、3年无瘤生存率均优于单纯RFA治疗组,差异有统计学意义(P均<0.05);两组间5年总体生存率差异无统计学意义(P=0.07)。对于肿瘤最大径<3cm的HCC,TACE联合RFA组与单纯RFA组1年、3年总体生存率及1年、3年无瘤生存率差异均无统计学意义(P均>0.05)。两组间严重并发症发生率差异无统计学意义(P=0.82)。结论 TACE联合RFA治疗HCC的近、中期疗效优于单纯RFA治疗,远期疗效无明显差异。
Objective To evaluate the efficacy and safety of TACE in combination with radiofrequency ablation (RFA) and simple RFA in the treatment of hepatocellular carcinoma (HCC) by Meta-analysis. Methods Chinese and English literatures were searched from January 2000 to November 2016 on the clinical randomized controlled trials of TACE combined with RFA and simple RFA in the treatment of HCC. Meta-analysis was used to extract information from the included studies. Results A total of 12 articles were enrolled in this study. The results of Meta analysis showed that the 1-year, 3-year overall survival rate and 1-year and 3-year tumor-free survival rate in TACE combined with RFA group were significantly higher than those in RFA alone group (all P <0.05) There was no significant difference in 5-year overall survival (P = 0.07). For 1 year, 3 years overall survival rate, and 1 year, 3 year disease free survival rate of HCC with tumor maximum diameter less than 3 cm, there was no significant difference between TACE group and RFA group (P> 0.05). There was no significant difference in the incidence of serious complications between the two groups (P = 0.82). Conclusions TACE combined with RFA in the treatment of HCC has better short-term and long-term curative effects than short-term RFA.