Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, PR China.
Central Laboratory, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, PR China.
Int J Surg. 2018 May;53:151-158. doi: 10.1016/j.ijsu.2018.03.049. Epub 2018 Mar 27.
To determine the clinical efficacy of TACE with platinum versus anthracyclines for hepatocellular carcinoma (HCC) patients using a meta-analysis.
We conducted a systematic review of the literature in PubMed, Embase, and the Cochrane Library database to discover relevant randomized controlled trials (RCTs) and observational studies. Data on therapeutic response, adverse event and overall survival rate from studies that compared TACE with platinum versus anthracyclines for HCC patients was extracted for pooled estimation. Subgroup analysis was used if further investigation was needed. The Q statistic and the I index statistic were used to assess heterogeneity. Publication bias was evaluated using Egger's test.
Four RCTs and seven observational studies containing 1405 patients were included in this meta-analysis. After comparing RCTs and observational studies separately, the pooled estimation results indicated that no significant difference existed between platinum and anthracyclines regarding therapeutic response, adverse event and overall survival rate. Furthermore, Egger's test revealed bias in pooled estimation of survival rate among RCTs.
Based on current results, we concluded that TACE with platinum revealed similar clinical efficacy compared with anthracyclines. And more relative studies in this field were expected in the future.
通过荟萃分析确定铂类药物与蒽环类药物联合 TACE 治疗肝细胞癌(HCC)患者的临床疗效。
我们在 PubMed、Embase 和 Cochrane Library 数据库中进行了系统的文献回顾,以发现相关的随机对照试验(RCT)和观察性研究。从比较 TACE 联合铂类药物与蒽环类药物治疗 HCC 患者的研究中提取关于治疗反应、不良事件和总生存率的数据,进行汇总估计。如果需要进一步研究,则进行亚组分析。使用 Q 统计量和 I 指数统计量评估异质性。使用 Egger 检验评估发表偏倚。
本荟萃分析纳入了四项 RCT 和七项观察性研究,共包含 1405 例患者。分别比较 RCT 和观察性研究后,汇总估计结果表明,铂类药物与蒽环类药物在治疗反应、不良事件和总生存率方面无显著差异。此外,Egger 检验显示 RCT 中生存率的汇总估计存在偏倚。
基于目前的结果,我们得出结论,TACE 联合铂类药物与蒽环类药物相比显示出相似的临床疗效。未来有望开展更多相关领域的研究。