干扰素治疗肝细胞癌的疗效和安全性：系统评价和荟萃分析。
Effect and safety of interferon for hepatocellular carcinoma: a systematic review and meta-analysis.
机构信息
Department of Integrative Medicine, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
出版信息
PLoS One. 2013 Sep 17;8(9):e61361. doi: 10.1371/journal.pone.0061361. eCollection 2013.
BACKGROUND
The effect of interferon(IFN) in the management of hepatocellular carcinoma (HCC) remains controversial, and no clear recommendations have been proposed.
OBJECTIVES
To evaluate the effect and safety of IFN for HCC.
METHODS
PubMed, OvidSP, and Cochrane Library were searched from their establishment date until August 30, 2012. Studies that met the inclusion criteria were systematically evaluated and then subjected to meta-analysis.
RESULTS
Thirteen randomized control trials (RCTs) involving 1344 patients were eligible for this study. When IFN was used as an adjuvant therapy for HCC patients after curative therapy, the meta-analysis showed that IFN reduced the 1-, 2-, 3-, 4-, and 5-year recurrence rates. Subgroup analysis showed that IFN reduced the 2-, 3-, 4-, and 5-year recurrence rates of hepatitis C viral (HCV)-related HCC. The effect of IFN for on hepatitis B virus(HBV)-related HCC patients could not be determined because of isufficient data. After surgical resection, adjuvant IFN therapy reduced the 4- and 5- recurrence rates. All studies reported that IFN could not improve the overall survival of HCV-realated HCC patients after curative therapies. Only one study showed that IFN was associated with better overall survival in HCC patients after curative therapy and subgroup of HCC patients after surgical resection. Thus, meta-analysis was not performed. Different treatment options were used as control to study the effect of IFN for intermediate and advanced HCC patients, thus meta-analysis was not appropriate. All included studies, except for one, reported that IFN treatment was well tolerated.
CONCLUSIONS
After curative therapies, adjuvant IFN reduced the recurrence of HCC. IFN did not improve the survival of HCV-related HCC patients after curative therapy. Whether IFN is effective for intermediate and advanced HCC patients could not be determined because of insufficient data. The toxicity of IFN was acceptable.
背景
干扰素（IFN）在肝细胞癌（HCC）治疗中的作用仍存在争议，目前尚未提出明确的建议。
目的
评估 IFN 治疗 HCC 的效果和安全性。
方法
从建库日期至 2012 年 8 月 30 日，检索 PubMed、OvidSP 和 Cochrane Library 数据库。对符合纳入标准的研究进行系统评价，然后进行荟萃分析。
结果
共纳入 13 项 RCT，纳入患者 1344 例。当 IFN 作为 HCC 患者根治性治疗后的辅助治疗时，荟萃分析显示 IFN 降低了 1、2、3、4 和 5 年的复发率。亚组分析显示 IFN 降低了丙型肝炎病毒（HCV）相关性 HCC 的 2、3、4 和 5 年复发率。由于数据不足，无法确定 IFN 对乙型肝炎病毒（HBV）相关性 HCC 患者的作用。在手术切除后，辅助 IFN 治疗降低了 4 年和 5 年的复发率。所有研究均报道 IFN 不能改善根治性治疗后 HCV 相关性 HCC 患者的总生存。只有一项研究表明 IFN 与根治性治疗后 HCC 患者和根治性治疗后 HCC 患者亚组的总生存相关。因此，未进行荟萃分析。不同的治疗选择作为对照来研究 IFN 对中晚期 HCC 患者的疗效，因此不适合进行荟萃分析。除一项研究外，所有纳入研究均报道 IFN 治疗耐受性良好。
结论
在根治性治疗后，辅助 IFN 降低了 HCC 的复发率。IFN 不能改善根治性治疗后 HCV 相关性 HCC 患者的生存。由于数据不足，无法确定 IFN 对中晚期 HCC 患者是否有效。IFN 的毒性是可以接受的。
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