经导管肝动脉灌注化疗与索拉非尼治疗巴塞罗那临床肝癌C期肝细胞癌患者的疗效比较：亚洲人群的荟萃分析
Transcatheter hepatic arterial infusion chemotherapy vs sorafenib in the treatment of patients with hepatocellular carcinoma of Barcelona Clinic Liver Cancer stage C: a meta-analysis of Asian population.
作者信息
Ni Jia-Yan, Liu Shan-Shan, Sun Hong-Liang, Wang Wei-Dong, Zhong Ze-Long, Hou Si-Nan, Chen Yao-Ting, Xu Lin-Feng
机构信息
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Interventional Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, People's Republic of China,
Department of Public Health, Sushe Community Health Service Center, Guangzhou 510220, Guangdong Province, People's Republic of China.
出版信息
Onco Targets Ther. 2018 Nov 6;11:7883-7894. doi: 10.2147/OTT.S156844. eCollection 2018.
OBJECTIVE
To compare the clinical efficacy and safety of transcatheter hepatic arterial infusion chemotherapy (HAIC) with those of sorafenib in the treatment of patients with hepatocellular carcinoma (HCC) of Barcelona Clinic Liver Cancer (BCLC) stage C.
METHODS
Potentially relevant studies comparing the clinical efficacy and safety of HAIC with those of sorafenib were searched using Medline, PubMed, Embase, Cochrane Library, and Chinese databases (Wanfang Data and China National Knowledge Infrastructure). Overall survival rate (OSR), tumor response rate, disease control rate (DCR), and serious adverse events (SAEs) were compared and analyzed. Pooled ORs with 95% CIs were calculated using either the fixed-effects model or the random-effects model. All statistical analyses were conducted using Review Manager (version 5.3) from the Cochrane Collaboration.
RESULTS
A total of 1,264 patients were included in this meta-analysis. The results of this study showed that HAIC was associated with significantly higher 1-, 2-, and 3-year OSRs than sorafenib (OR 1.88, 95% CI1-year: [1.27-2.78], 1-year=0.002; OR 2.15, 95% CI2-year: [1.06-4.37], 2-year=0.03; OR 7.90, 95% CI3-year: [2.12-29.42], 3-year=0.002). Compared to sorafenib, HAIC was associated with superior complete response (CR), partial response (PR), and objective response rate (ORR) (OR 3.90, 95% CI: [1.89-8.03], =0.0002; OR 3.47, 95% CI: [2.31-5.24], <0.00001; OR 3.02, 95% CI: [2.05-4.45], <0.0001). There was no statistically significant difference between HAIC and sorafenib in stable disease (SD), progressive disease (PD), DCR, and SAEs (OR 0.86, 95% CI: [0.51-1.45], =0.56; OR 0.62, 95% CI: [0.35-1.11], =0.11; OR 0.53, 95% CI: [0.14-1.92], =0.33).
CONCLUSION
This study showed that HAIC was associated with better efficacy than sorafenib in terms of OSR and tumor response. Therefore, HAIC can be considered as an alternative treatment option for patients with HCCs of BCLC stage C.
目的
比较经导管肝动脉灌注化疗（HAIC）与索拉非尼治疗巴塞罗那临床肝癌（BCLC）C期肝细胞癌（HCC）患者的临床疗效和安全性。
方法
使用Medline、PubMed、Embase、Cochrane图书馆和中文数据库（万方数据和中国知网）检索比较HAIC与索拉非尼临床疗效和安全性的潜在相关研究。比较并分析总生存率（OSR）、肿瘤反应率、疾病控制率（DCR）和严重不良事件（SAE）。采用固定效应模型或随机效应模型计算合并的OR值及95%置信区间（CI）。所有统计分析均使用Cochrane协作网的Review Manager（5.3版）进行。
结果
本荟萃分析共纳入1264例患者。研究结果表明，HAIC组1年、2年和3年的OSR显著高于索拉非尼组（OR 1.88，95%CI 1年：[1.27 - 2.78]，P1年 = 0.002；OR 2.15，95%CI 2年：[1.06 - 4.37]，P2年 = 0.03；OR 7.90，95%CI 3年：[2.12 - 29.42]，P3年 = 0.002）。与索拉非尼相比，HAIC组的完全缓解（CR）、部分缓解（PR）和客观缓解率（ORR）更高（OR 3.90，95%CI：[1.89 - 8.03]，P = 0.0002；OR 3.47，95%CI：[2.31 - 5.24]，P < 0.00001；OR 3.02，95%CI：[2.05 - 4.45]，P < 0.0001）。HAIC组与索拉非尼组在疾病稳定（SD）、疾病进展（PD）、DCR和SAE方面无统计学显著差异（OR 0.86，95%CI：[0.51 - 1.45]，P = 0.56；OR 0.62，95%CI：[0.35 - 1.11]，P = 0.11；OR 0.53，95%CI：[0.14 - 1.92]，P = 0.33）。
结论
本研究表明，在OSR和肿瘤反应方面，HAIC的疗效优于索拉非尼。因此，HAIC可被视为BCLC C期HCC患者的一种替代治疗选择。
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