Zhou Xueping, Tang Zhaohui, Wang Jiandong, Lin Peiyi, Chen Zhisheng, Lv Lisheng, Quan Zhiwei, Liu Yingbin
Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University Shanghai 200092, China.
Int J Clin Exp Med. 2014 Nov 15;7(11):3892-903. eCollection 2014.
We conducted a meta-analysis to evaluate the efficacy and toxicity of DEB-TACE in the treatment of patients with intermediate-stage HCC.
Studies published in PubMed, Embase and Web of Science, were systematically reviewed to identify those that assessed the efficacy and toxicity of DEB-TACE in the treatment of patients with HCC. Hazard ratio, risk ratioand 95% confidence intervalswere calculated, using a fixed-effects model or a random-effects model.
Nine studies with a total of 830 patients met the inclusion criteria were included in this study. DEB-TACE significantly improved overall survivaland progression free survival, and also increased objective response rateand disease control rate. However, in subgroup analyses, pooled results showed that, the survival benefits of DEB-TACE were not found in the randomized controlled trials, but were observed in Non-RCTs. The incidence of most common adverse events, including nausea, pain, fever, and fatigue, was not significant difference between the DEB-TACE group and conventional TACEgroup.
Despite DEB-TACE significantly prolonged the survival and response rate in the patients with HCC, the conclusion about the survival benefits should be interpreted with caution, since these findings were only found in retrospective Non-RCTs, and not in prospective RCTs.
我们进行了一项荟萃分析，以评估载药微球经动脉化疗栓塞术（DEB-TACE）治疗中期肝细胞癌（HCC）患者的疗效和毒性。
系统回顾了发表于PubMed、Embase和科学网的研究，以确定那些评估DEB-TACE治疗HCC患者疗效和毒性的研究。采用固定效应模型或随机效应模型计算风险比、比值比和95%置信区间。
本研究纳入了9项共830例符合纳入标准的研究。DEB-TACE显著改善了总生存期和无进展生存期，还提高了客观缓解率和疾病控制率。然而，在亚组分析中，汇总结果显示，DEB-TACE的生存获益在随机对照试验中未发现，但在非随机对照试验中观察到。包括恶心、疼痛、发热和疲劳在内的最常见不良事件的发生率在DEB-TACE组和传统经动脉化疗栓塞术（TACE）组之间无显著差异。
尽管DEB-TACE显著延长了HCC患者的生存期和缓解率，但关于生存获益的结论应谨慎解读，因为这些发现仅在回顾性非随机对照试验中发现，而在前瞻性随机对照试验中未发现。
