阿帕替尼联合经动脉化疗栓塞术治疗肝细胞癌的疗效与安全性：一项荟萃分析
The efficacy and safety of Apatinib combined with TACE in the treatment of hepatocellular carcinoma: a meta-analysis.
作者信息
Gong Anan, Li Xiaofei
机构信息
Department of Hepatobiliary Surgery, YiWu Central Hospital, No. 519 Nan men Street, Yiwu, Zhejiang, 322000, China.
Department of Infectious Diseases, YiWu Central Hospital, No. 519 Nan men Street, Yiwu, Zhejiang, 322000, China.
出版信息
World J Surg Oncol. 2022 Mar 4;20(1):69. doi: 10.1186/s12957-021-02451-8.
BACKGROUND
The timely and effective treatments are vital to the prognosis of patients with hepatocellular carcinoma, and the role of Apatinib combined with TACE in the treatment of hepatocellular carcinoma remains unclear. Therefore, we aimed to conduct a systematic review and meta-analysis to evaluate the efficacy and safety of Apatinib combined with transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma.
METHODS
We searched for randomized controlled trials (RCTs) on Apatinib and TACE use in the treatment of hepatocellular carcinoma. Cochrane Central Register of Controlled Trials, Embase, PubMed, China Biomedical Literature Database, China Knowledge Network, Wanfang Database, and Weipu Chinese Science and Technology Journal Database were searched up to 16 April 2021. Two researchers independently screened the literature and extracted data according to the inclusion and exclusion criteria. RevMan 5.3 software was used for Meta-analysis. This meta-analysis protocol had been registered online (available at: https://inplasy.com/inplasy-2021-6-0047/ ).
RESULTS
A total of 14 RCTs involving 936 hepatocellular carcinoma patients were included. The objective remission rate (OR = 2.93, 95% CI 2.17-3.95), 1-year survival (OR = 2.47, 95% CI 1.65-3.68), 2-year survival (OR = 2.67, 95% CI 1.41-5.04), the incidence of hand-foot syndrome (OR = 32.09, 95% CI 10.87-94.74) and the incidence of proteinuria (OR = 14.79, 95% CI 6.07-36.06) of the Apatinib + TACE group was significantly higher than that of the TACE group (all P < 0.05). There were no significant differences in the incidence of myelosuppression (OR = 1.01, 95% CI 0.61-1.67), the incidence of hypertension (OR = 7.56, 95% CI 0.95-1.67, P = 60.17) between Apatinib + TACE and TACE group (all P > 0.05).
CONCLUSIONS
Apatinib combined with TACE is more effective than TACE alone in the treatment of hepatocellular carcinoma, but it has certain adverse reactions.
背景
及时有效的治疗对肝细胞癌患者的预后至关重要，阿帕替尼联合经动脉化疗栓塞术（TACE）治疗肝细胞癌的作用仍不明确。因此，我们旨在进行一项系统评价和荟萃分析，以评估阿帕替尼联合TACE治疗肝细胞癌的疗效和安全性。
方法
我们检索了关于阿帕替尼和TACE用于治疗肝细胞癌的随机对照试验（RCT）。检索截至2021年4月16日的Cochrane对照试验中心注册库、Embase、PubMed、中国生物医学文献数据库、中国知网、万方数据库和维普中文科技期刊数据库。两名研究人员根据纳入和排除标准独立筛选文献并提取数据。使用RevMan 5.3软件进行荟萃分析。该荟萃分析方案已在网上注册（可在：https://inplasy.com/inplasy-2021-6-0047/获取）。
结果
共纳入14项RCT，涉及936例肝细胞癌患者。阿帕替尼+TACE组的客观缓解率（OR = 2.93，95%CI 2.17 - 3.95）、1年生存率（OR = 2.47，95%CI 1.65 - 3.68）、2年生存率（OR = 2.67，95%CI 1.41 - 5.04）、手足综合征发生率（OR = 32.09，95%CI 10.87 - 94.74）和蛋白尿发生率（OR = 14.79，95%CI 6.07 - 36.06）均显著高于TACE组（均P < 0.05）。阿帕替尼+TACE组与TACE组在骨髓抑制发生率（OR = 1.01，95%CI 0.61 - 1.67）、高血压发生率（OR = 7.56，95%CI 0.95 - 1.67，P = 60.17）方面无显著差异（均P > 0.05）。
结论
阿帕替尼联合TACE治疗肝细胞癌比单纯TACE更有效，但有一定不良反应。
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