辅助聚乙二醇化干扰素治疗可改善根治性治疗后肝炎相关肝细胞癌患者的生存结局：一项荟萃分析。
Adjuvant pegylated interferon therapy improves the survival outcomes in patients with hepatitis-related hepatocellular carcinoma after curative treatment: A meta-analysis.
作者信息
Wu Jiansong, Yin Zhiwei, Cao Liuxia, Xu Xiaodan, Yan Tao, Liu Changting, Li Diangeng
机构信息
Department of Infection Disease, General Hospital of the PLA Rocket Force Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Disease Department of Hepatobiliary Surgery, General Hospital of the PLA Rocket Force Nanlou Respiratory Diseases Department, Chinese PLA General Hospital, Beijing, China.
出版信息
Medicine (Baltimore). 2018 Jul;97(28):e11295. doi: 10.1097/MD.0000000000011295.
BACKGROUND
Hepatocellular carcinoma (HCC) is one of the most common cancers and the second leading cause of cancer-related deaths in men worldwide. Surgical resection of HCC remains the mainstay treatment procedure. As a result of hepatitis viral infection, the postoperative survival outcome in patients with HCC is not satisfactory. Recently, studies have reported that due to its treatment effect on hepatitis infection, pegylated interferon (Peg-IFN)-based therapy could improve the survival outcome after the treatment of hepatitis-related HCC. However, the postoperative effect of this regimen on the survival outcomes in patients with hepatitis-related HCC remains debatable. The present study conducted a meta-analysis to evaluate the effects of adjuvant Peg-IFN-based therapy on the survival outcomes in patients with hepatitis-related HCC after the curative treatment.
METHODS
A systematic search was conducted to identify studies on the survival outcomes in patients with hepatitis-related HCC after a curative treatment with adjuvant Peg-IFN. PubMed, EmBase, and Cochrane Library databases were searched until September 20, 2017. The retrieved studies were independently assessed by 2 reviewers, to identify the potentially eligible studies and extract data of interest. STATA software (Version 10.0, STATA Corporation, College Station, Texas) software was used for all statistical analyses.
RESULTS
The pooled results showed that adjuvant Peg-IFN-based therapy improved the 3- and 5-year recurrence-free survival (RFS) rates of patients with hepatitis-related HCC (3-year RFS, HR = 0.80; 95% CI: 0.64-0.99, P = .04; P = .81 for heterogeneity; 5-year RFS, HR = 0.82; 95% CI: 0.67-0.99, P = .04; P = .84 for heterogeneity). For the 5-year overall survival (OS) outcomes of Peg-IFN therapy for hepatitis-related HCC after the curative treatment, the pooled results showed a significant difference between the 2 groups (HR = 0.67; 95% CI: 0.47-0.97, P = .03; P = .99 for heterogeneity).
CONCLUSIONS
Adjuvant Peg-IFN-based therapy could improve the RFS and OS outcomes in patients after curative treatment of hepatitis-related HCC, with no severe adverse effects.
背景
肝细胞癌（HCC）是全球男性中最常见的癌症之一，也是癌症相关死亡的第二大主要原因。肝癌手术切除仍是主要的治疗手段。由于肝炎病毒感染，肝癌患者的术后生存结果并不理想。最近，有研究报道，基于聚乙二醇化干扰素（Peg-IFN）的疗法因其对肝炎感染的治疗效果，可改善肝炎相关肝癌治疗后的生存结果。然而，该方案对肝炎相关肝癌患者生存结果的术后影响仍存在争议。本研究进行了一项荟萃分析，以评估辅助性基于Peg-IFN的疗法对肝炎相关肝癌患者根治性治疗后生存结果的影响。
方法
进行系统检索，以确定关于辅助性Peg-IFN根治性治疗后肝炎相关肝癌患者生存结果的研究。检索了PubMed、EmBase和Cochrane图书馆数据库，直至2017年9月20日。检索到的研究由2名评审员独立评估，以确定潜在符合条件的研究并提取感兴趣的数据。所有统计分析均使用STATA软件（版本10.0，STATA公司，德克萨斯州大学城）。
结果
汇总结果显示，辅助性基于Peg-IFN的疗法可提高肝炎相关肝癌患者的3年和5年无复发生存（RFS）率（3年RFS，HR = 0.80；95%CI：0.64 - 0.99，P = 0.04；异质性P = 0.81；5年RFS，HR = 0.82；95%CI：0.67 - 0.99，P = 0.04；异质性P = 0.84）。对于根治性治疗后肝炎相关肝癌的Peg-IFN治疗的5年总生存（OS）结果，汇总结果显示两组之间存在显著差异（HR = 0.67；95%CI：0.47 - 0.97，P = 0.03；异质性P = 0.99）。
结论
辅助性基于Peg-IFN的疗法可改善肝炎相关肝癌患者根治性治疗后的RFS和OS结果，且无严重不良反应。
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