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碘[I]美妥昔单抗注入联合经动脉化疗栓塞术治疗肝细胞癌疗效与安全性的Meta分析

A meta-analysis of the efficacy and safety of iodine [I] metuximab infusion combined with TACE for treatment of hepatocellular carcinoma.

作者信息

Fan Wenzhe, Wu Yanqin, Lu Mingjian, Yao Wang, Cui Wei, Zhao Yue, Wang Yu, Li Jiaping

机构信息

Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan 2 Road, Guangzhou 510080, China.

Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-Sen University, No. 58 Zhongshan 2 Road, Guangzhou 510080, China.

出版信息

Clin Res Hepatol Gastroenterol. 2019 Aug;43(4):451-459. doi: 10.1016/j.clinre.2018.09.006. Epub 2018 Oct 19.

Abstract

OBJECTIVES

To compare the efficacy and safety of combination iodine [I] metuximab infusion and transcathether arterial chemoembolization (TACE) with those of TACE-alone for hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

PubMed, Cochrane Library, Embase, Web of Science, China Biology Medicine, China Science and Technology Journal Database, Wan Fang Data, and Chinese knowledge resource integrated databases were used for the literature search regarding controlled clinical trials comparing combination TACE and iodine [I] metuximab infusion with TACE-alone for HCC treatment before February 1, 2016. The Jadad system evaluation method for research quality and RevMan 5.0 software were used for the meta-analysis.

RESULTS

In total, 1302 patients from 10 studies were included. The meta-analysis showed that the combination TACE and iodine [I] metuximab infusion treatment for HCC was more effective than TACE alone, including 6-month survival (odds ratio [OR] = 2.05, 95% confidence interval [CI]: 1.41-2.98, P = 0.0002), 1-year survival (OR = 1.90, 95% CI: 1.41-2.55, P < 0.00001), and the total response rate (OR = 2.91, 95% CI: 2.08-4.07, P < 0.00001). Nine studies reported adverse reactions, mainly comprising poor appetite, nausea, vomiting, and abdominal discomfort. Fever, chills, and bone marrow suppression were more common in the combined treatment group, but abnormal liver function was not different between the two treatment groups. There was no report on serious complications or death directly related to either treatment.

CONCLUSIONS

Compared with TACE alone, the combination of TACE with iodine [I] metuximab infusion for treating unresectable HCC may improve local efficacy and overall survival in these types of patients.

摘要

目的

比较碘[I]美妥昔单抗联合经动脉化疗栓塞术(TACE)与单纯TACE治疗肝细胞癌(HCC)的疗效和安全性。

材料与方法

使用PubMed、Cochrane图书馆、Embase、Web of Science、中国生物医学数据库、中国科技期刊数据库、万方数据和中国知识资源总库,检索2016年2月1日前比较碘[I]美妥昔单抗联合TACE与单纯TACE治疗HCC的对照临床试验的文献。采用Jadad系统评价方法评估研究质量,并使用RevMan 5.0软件进行荟萃分析。

结果

共纳入10项研究的1302例患者。荟萃分析表明,碘[I]美妥昔单抗联合TACE治疗HCC比单纯TACE更有效,包括6个月生存率(比值比[OR]=2.05,95%置信区间[CI]:1.41 - 2.98,P = 0.0002)、1年生存率(OR = 1.90,95%CI:1.41 - 2.55,P < 0.00001)和总缓解率(OR = 2.91,95%CI:2.08 - 4.07,P < 0.00001)。9项研究报告了不良反应,主要包括食欲减退、恶心、呕吐和腹部不适。联合治疗组发热、寒战和骨髓抑制更为常见,但两组肝功能异常情况无差异。没有关于与任何一种治疗直接相关的严重并发症或死亡的报告。

结论

与单纯TACE相比,碘[I]美妥昔单抗联合TACE治疗不可切除的HCC可能提高这类患者的局部疗效和总生存率。

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