重组人腺病毒 p53 联合经导管动脉化疗栓塞治疗肝癌的Meta 分析。

Recombinant human adenovirus p53 combined with transcatheter arterial chemoembolization for liver cancer: A meta-analysis.

机构信息

Department of Radiation, Xuzhou first People's Hospital, Jiangsu, China.

Xuzhou Medical University, Jiangsu, China.

出版信息

PLoS One. 2023 Dec 21;18(12):e0295323. doi: 10.1371/journal.pone.0295323. eCollection 2023.

DOI:10.1371/journal.pone.0295323

PMID:38127912

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10735047/

Abstract

OBJECTIVES

To compare the clinical curative effects, survival and complications of recombinant human adenovirus-p53 (rAd-p53) combined with transcatheter arterial chemoembolization (TACE) versus TACE for the treatment of liver cancer.

METHODS

We searched all the eligible studies of rAd-p53 plus TACE versus control group had only TACE in the treatment of liver cancer, which were retrieved from CNKI, Wanfang database, CBM, VIP, PubMed, EMBase, The Chrance of Library, Web of Science from its inception to august 2022.

RESULTS

A total of 17 studies were included, which involved 1045 patients. The results of the meta analysis indicated that the the rAd-p53combined with TACE markedly improved the patients' complete remission(OR = 2.19, 95% CI:1.13-4.22, P = 0.02), partial remission (OR = 2.22, 95% CI:1.67-2.94, P<0.00001), objective tumor response rate (OR = 2.58, 95% CI:1.95-3.41, P<0.00001) and disease control rate(OR = 2.39, 95% CI:1.65-3.47, P<0.00001) compared with TACE alone. And our results showed that rAd-p53combined with TACE had better survival benefit [6-month OS (OR = 3.41, 95% CI: 1.62-7.14, p = 0.001); 1-year OS (OR = 1.95, 95% CI: 1.28-2.96, p = 0.002)] and better quality of life(MD = 5.84, 95% CI:2.09-9.60, P = 0.002). In addition, the immunity of the patients was enhanced by the combination therapy, as demonstrated by the increase in the ratio of CD4+ to CD4+/CD8+. In adverse effects, except for fever in the TACE combined with rAd-p53 group, which was higher than that in the TACE group(OR = 2.62, 95% CI:2.02-3.49, P<0.00001), all other adverse effects were lower in the TACE combined with rAd-p53 group than in the TACE group.

CONCLUSION

RAd-p53 combined with TACE for liver cancer showed significant advantages in terms of clinical efficacy, survival rate, and safety compared to the TACE alone, and effectively improved patient quality of life and immune function.

SYSTEMATIC REVIEW REGISTRATION

https://inplasy.com/inplasy-2022-9-0127/.

摘要

目的

比较重组人腺病毒-p53（rAd-p53）联合经导管动脉化疗栓塞（TACE）与 TACE 治疗肝癌的临床疗效、生存率和并发症。

方法

我们检索了从建库至 2022 年 8 月，中国知网、万方数据库、中国生物医学文献数据库、维普数据库、PubMed、EMBase、The Chrance of Library、Web of Science 中所有关于 rAd-p53 联合 TACE 与对照组仅接受 TACE 治疗肝癌的研究。

结果

共纳入 17 项研究，共 1045 例患者。Meta 分析结果表明，rAd-p53 联合 TACE 可显著提高患者完全缓解率（OR=2.19，95%CI：1.13-4.22，P=0.02）、部分缓解率（OR=2.22，95%CI：1.67-2.94，P<0.00001）、客观肿瘤反应率（OR=2.58，95%CI：1.95-3.41，P<0.00001）和疾病控制率（OR=2.39，95%CI：1.65-3.47，P<0.00001），与单独 TACE 相比。我们的研究结果表明，rAd-p53 联合 TACE 具有更好的生存获益[6 个月 OS（OR=3.41，95%CI：1.62-7.14，p=0.001）；1 年 OS（OR=1.95，95%CI：1.28-2.96，p=0.002）]和更好的生活质量（MD=5.84，95%CI：2.09-9.60，P=0.002）。此外，联合治疗还增强了患者的免疫功能，表现为 CD4+/CD8+比值升高。在不良反应方面，除 rAd-p53 联合 TACE 组发热发生率高于 TACE 组（OR=2.62，95%CI：2.02-3.49，P<0.00001）外，rAd-p53 联合 TACE 组其他不良反应发生率均低于 TACE 组。