International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China; Guangxi University of Chinese Medicine, Nanning, China.
Ruikang Clinical Faculty of Guangxi University of Chinese Medicine, Nanning, China.
Turk J Gastroenterol. 2023 Apr;34(4):311-321. doi: 10.5152/tjg.2023.22383.
This meta-analysis aimed to determine whether sorafenib combined with hepatic arterial infusion chemotherapy is beneficial for advanced hepatocellular carcinoma. We searched PubMed, Cochrane Library, and Embase to identify comparative studies evaluating sorafenib plus hepatic arterial infusion chemotherapy versus sorafenib for advanced hepatocellular carcinoma. Overall survival, progression-free survival, objective response rate, rate of progressive disease, and adverse events were evaluated. This meta-analysis included 5 randomized controlled trials (690 patients). Pooled estimates showed that compared with sorafenib, sorafenib plus hepatic arterial infusion chemotherapy was associated with higher overall survival (hazard ratio = 0.52, 95% CI: 0.28-0.95, P = .03), progressionfree survival (hazard ratio = 0.57, 95% CI: 0.33-0.98, P = .04), objective response rate (risk ratio = 3.84, 95% CI: 1.23-12.05, P = .02), as well as higher rates of neutropenia (risk ratio = 7.90, 95% CI: 3.0-20.78, P < .0001) and thrombocytopenia (risk ratio = 2.73, 95% CI: 1.70- 4.36, P < .0001), but had no significant influence for rate of progressive disease (risk ratio = 0.76, 95% CI: 0.43-1.37, P = .37). Sorafenib plus hepatic arterial infusion chemotherapy improved overall survival, progression-free survival, and objective response rate, but it had no effect on the rate of progressive disease. Combination therapy has a survival benefit for advanced hepatocellular carcinoma patients, and adverse events can be accepted. However, more large-scale randomized controlled trials are needed for further investigation.
这项荟萃分析旨在确定索拉非尼联合肝动脉灌注化疗是否对晚期肝细胞癌有益。我们检索了 PubMed、Cochrane Library 和 Embase，以确定评估索拉非尼联合肝动脉灌注化疗与索拉非尼治疗晚期肝细胞癌的比较研究。评估了总生存期、无进展生存期、客观缓解率、疾病进展率和不良事件。这项荟萃分析包括 5 项随机对照试验（690 例患者）。汇总估计表明，与索拉非尼相比，索拉非尼联合肝动脉灌注化疗与更高的总生存期相关（风险比=0.52，95%置信区间：0.28-0.95，P=0.03）、无进展生存期（风险比=0.57，95%置信区间：0.33-0.98，P=0.04）、客观缓解率（风险比=3.84，95%置信区间：1.23-12.05，P=0.02），以及更高的中性粒细胞减少发生率（风险比=7.90，95%置信区间：3.0-20.78，P<0.0001）和血小板减少发生率（风险比=2.73，95%置信区间：1.70-4.36，P<0.0001），但对疾病进展率无显著影响（风险比=0.76，95%置信区间：0.43-1.37，P=0.37）。索拉非尼联合肝动脉灌注化疗可提高总生存期、无进展生存期和客观缓解率，但对疾病进展率无影响。联合治疗对晚期肝细胞癌患者有生存获益，且不良事件可被接受。然而，还需要更多大规模的随机对照试验来进一步研究。
