Yu Yihui, Fu Jinman, Xia Pengcheng, Chu Chunyan
Radiology Department, Haining People's Hospital of Zhejiang Province, Haining, China.
Infectious Disease Department, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.
Transl Cancer Res. 2022 May;11(5):1297-1308. doi: 10.21037/tcr-22-816.
Transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) intervention in prolonging the long-term survival and prognosis of patients with liver cancer are still controversy compared with the traditional interventional therapy of RFA alone. This meta-analysis aimed to compare the efficacy and safety of combination therapy versus RFA alone.
The related articles were searched in PubMed, Embase, MEDLINE, Science Direct, The Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Science and Technology Journal Database, and China Biomedical Literature Database (CBM). The Chinese and English search keywords included transcatheter arterial chemoembolization, TACE, radiofrequency ablation, RFA, primary liver cancer, and liver tumor. The five evaluation criteria of randomized controlled trials (RCTs) in Cochrane RoB 2.0 repeatedly independently evaluated the bias risks involved in the study and cross-checked the results.
A total of 7 articles were included, and the results of bias risk assessment show that 6 articles described the generation of random sequences in detail; There were 3 articles describing allocation concealment in detail; Operator blindness was used in 4 articles; The outcome indicators of 7 documents were complete. The 3-year overall survival rate of the RFA combined with TACE group was significantly better than that of the RFA group [odds ratio (OR) =1.97, 95% confidence interval (CI): 1.42-2.74, Z=4.05, P<0.0001]. The 1-year and 3-year tumor recurrence-free survival rates in the RFA combined with TACE group were significantly better than those in the RFA group (OR =1.88, 95% CI: 1.28-2.76, Z=3.23, P=0.001; OR =2.11, 95% CI: 1.37-3.24, Z=3.38, P=0.0007). There was no significant difference in the complication rate of patients with primary liver cancer between the RFA combined with TACE group and the RFA group (OR =0.79, 95% CI: 0.45-1.39, Z=0.81, P=0.42).
Meta-analysis results confirmed that TACE combined with RFA was safe and effective in the treatment of primary liver cancer, and can improve the overall survival and recurrence-free survival of patients with primary liver cancer.
与单纯传统射频消融（RFA）介入治疗相比，经动脉化疗栓塞术（TACE）联合射频消融（RFA）干预在延长肝癌患者长期生存及预后方面仍存在争议。本荟萃分析旨在比较联合治疗与单纯RFA的疗效和安全性。
在PubMed、Embase、MEDLINE、Science Direct、Cochrane图书馆、中国知网（CNKI）、万方数据库、中国科技期刊数据库和中国生物医学文献数据库（CBM）中检索相关文章。中英文检索关键词包括经动脉化疗栓塞术、TACE、射频消融、RFA、原发性肝癌和肝肿瘤。采用Cochrane RoB 2.0中随机对照试验（RCT）的五项评估标准对研究中涉及的偏倚风险进行反复独立评估并交叉核对结果。
共纳入7篇文章，偏倚风险评估结果显示，6篇文章详细描述了随机序列的产生；3篇文章详细描述了分配隐藏；4篇文章采用了操作者盲法；7篇文献的结局指标完整。RFA联合TACE组的3年总生存率显著优于RFA组[比值比（OR）=1.97，95%置信区间（CI）：1.42 - 2.74，Z = 4.05，P < 0.0001]。RFA联合TACE组的1年和3年无瘤复发生存率显著优于RFA组（OR = 1.88，95% CI：1.28 - 2.76，Z = 3.23，P = 0.001；OR = 2.11，95% CI：1.37 - 3.24，Z = 3.38，P = 0.0007）。RFA联合TACE组与RFA组原发性肝癌患者的并发症发生率无显著差异（OR = 0.79，95% CI：0.45 - 1.39，Z = 0.81，P = 0.42）。
荟萃分析结果证实，TACE联合RFA治疗原发性肝癌安全有效，可提高原发性肝癌患者的总生存率和无瘤生存率。
