Department of Gastroenterology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China.
J Dig Dis. 2010 Aug;11(4):208-14. doi: 10.1111/j.1751-2980.2010.00440.x.
To evaluate the effect of prophylactic regional liver chemotherapy during the perioperative period on improving survival and preventing liver metastases in patients with colorectal cancer (CRC).
A comprehensive retrieval of the relevant literature was performed by searching major biomedical database, mainly from Medline and Embase. Studies reported in the selected literature were categorized into two subgroups according to the type of therapy: a perioperative hepatic artery infusion subgroup and a perioperative portal vein infusion subgroup. Mortality and liver metastasis were analyzed using a fixed-effects model. Statistical analysis was performed using Review Manager software.
The results of this meta-analysis illustrated that survival and the rate of liver metastasis in patients receiving perioperative hepatic artery infusion (HAI) chemotherapy were significantly better than for those receiving surgery alone (pooled relative risk 0.46 [95% CI: 0.31-0.69] and 0.44 [95% CI: 0.28-0.68], respectively, P= 0.0002), while survival and the rate of liver metastasis in patients receiving perioperative portal vein infusion (PVI) chemotherapy were not significantly different from those receiving surgery alone (pooled relative risk 0.98 [95% CI: 0.89-1.09], P= 0.73 and 0.86 [95% CI: 0.72-1.02], respectively. P= 0.08).
As a method of regional liver chemotherapy, HAI might be able to improve survival and reduce the rate of liver metastasis in patients with advanced CRC.
评估围手术期预防性肝区域化疗对改善结直肠癌（CRC）患者生存和预防肝转移的效果。
通过检索主要生物医学数据库（主要是 Medline 和 Embase），全面检索相关文献。根据治疗类型，将所选文献中的研究分为两组：肝动脉灌注亚组和门静脉灌注亚组。使用固定效应模型分析死亡率和肝转移率。使用 Review Manager 软件进行统计分析。
这项荟萃分析的结果表明，接受围手术期肝动脉灌注（HAI）化疗的患者的生存率和肝转移率明显优于单独手术组（合并相对风险 0.46 [95% CI：0.31-0.69] 和 0.44 [95% CI：0.28-0.68]，P=0.0002），而接受围手术期门静脉灌注（PVI）化疗的患者的生存率和肝转移率与单独手术组无显著差异（合并相对风险 0.98 [95% CI：0.89-1.09]，P=0.73 和 0.86 [95% CI：0.72-1.02]，P=0.08）。
作为一种肝区域化疗方法，HAI 可能能够改善晚期 CRC 患者的生存并降低肝转移率。
