Yang Shu, Lin Qi, Lin Wei, Hu Weilei, Wang Guosheng
Department of Gastroenterology, No. 202 Hospital of Chinese People's Liberation Army, No. 5, Guangrong Street, HePing District, Shenyang, Liaoning, 110003, China.
Department of Pharmacy, Integrated Traditional and Western Medicine Hospital of Taizhou, Taizhou, China.
World J Surg Oncol. 2016 Jun 9;14(1):159. doi: 10.1186/s12957-016-0912-7.
The objective of this study is to evaluate the efficacy of adjuvant interferon therapy for hepatitis B virus-related hepatocellular carcinoma (HCC) after different previous therapy.
An electronic search for articles about adjuvant treatment with IFN for patients with HCC published between 2000 and 2015 was conducted in MEDLINE, PubMed, Cochrane Library, and EMBASE databases. All data was tested with Stata12.0 software.
Six trials with a total of 1054 subjects were screened according to inclusion and exclusion standards. Five hundred and seventeen HCC patients were treated with adjuvant treatment with IFN and 537 patients with placebo. Compared to the control group, both the recurrence rate and death rate of HCC in IFN group were statistically lower, especially after transhepatic arterial chemotherapy and embolization (TACE) treatment and both TACE and resection according to subgroup analysis. There is no statistical significance on the both recurrence and death rate of HBV-related hepatocellular carcinoma after surgical resection treatment (RR = 0.96, 95 % CI, 0.84 to 1.1, p = 0.59 for recurrence and RR = 0.78, 95 % CI, 0.60 to 1.04, p = 0.09 for death rates).
Adjuvant IFN therapy may significantly reduced mortality as well as recurrence rate of patients with HBV-related HCC after no matter what the previous treatment. On the other hand, there is no statistical significance on the recurrence rate and mortality after surgical resection only. More research is needed into the relationship between effect of adjuvant interferon therapy and previous therapy, especially TACE.
本研究旨在评估不同前期治疗后辅助性干扰素治疗对乙型肝炎病毒相关肝细胞癌(HCC)的疗效。
在MEDLINE、PubMed、Cochrane图书馆和EMBASE数据库中对2000年至2015年间发表的关于HCC患者使用干扰素进行辅助治疗的文章进行电子检索。所有数据均使用Stata12.0软件进行检验。
根据纳入和排除标准筛选出6项试验,共1054名受试者。517例HCC患者接受干扰素辅助治疗,537例患者接受安慰剂治疗。与对照组相比,干扰素组HCC的复发率和死亡率在统计学上均较低,尤其是在经肝动脉化疗栓塞术(TACE)治疗后以及根据亚组分析在TACE和手术切除后。手术切除治疗后,HBV相关肝细胞癌的复发率和死亡率均无统计学意义(复发率RR = 0.96,95%可信区间为0.84至1.1,p = 0.59;死亡率RR = 0.78,95%可信区间为0.60至1.04,p = 0.09)。
无论前期治疗如何,辅助性干扰素治疗可能显著降低HBV相关HCC患者的死亡率和复发率。另一方面,仅手术切除后的复发率和死亡率无统计学意义。需要进一步研究辅助性干扰素治疗效果与前期治疗,尤其是TACE之间的关系。