引用本文:温 路,吴忠均,沈 艾,张 超,魏续福,刘 锐.射频消融联合经肝动脉化疗栓塞治疗肝癌的疗效与安全性系统评价[J].重庆医科大学学报,2014,38(7):908~914
射频消融联合经肝动脉化疗栓塞治疗肝癌的疗效与安全性系统评价
Efficacy and safety of radiofrequency ablation plus transcatheter arterial chemoembolization for hepatocellular carcinoma:a systematic review
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中文关键词:  肝细胞性肝癌  射频消融  肝动脉化疗栓塞  系统评价
英文关键词:hepatocellular carcinoma  radiofrequency ablation  transcatheter arterial chemoembolization  systematic review
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温 路,吴忠均,沈 艾,张 超,魏续福,刘 锐 重庆医科大学附属第一医院肝胆外科重庆 400016 
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中文摘要:
      目的:系统评价射频消融(radiofrequency ablation,RFA)联合经肝动脉化疗栓塞(transcatheter arterial chemoemboliza-tion,TACE)治疗肝细胞性肝癌(hepatocellular carcinoma,HCC)的有效性与安全性。方法:计算机检索PubMed、Cochrane Li-brary、EMBase及CNKI数据库中1978至2013年间的数据,只纳入比较RFA+TACE与单独RFA治疗HCC的随机对照试验。结果:按照入选标准,有9 项临床试验纳入本研究。与单独RFA治疗HCC相比,RFA TACE能显著提高患者1、3、5年总生存期(OR1年=2.34,95%CI=1.54~3.57,P=0.000;OR3年=1.99,95%CI=1.43~2.77,P=0.000;OR5年=2.26,95%CI=1.03~4.95,P=0.04)和1、3年无肿瘤复发生存期(OR1年=1.74,95%CI=1.16~2.63,P=0.008;OR3年=2.47,95%CI=1.61~3.80,P=0.000)。2组之间主要并发症发生率无明显差别(OR=1.24,95%CI=0.79~1.95,P=0.36)。亚组分析显示:RFA TACE治疗能明显提高直径在3~5 cm之间的HCC患者的1、3年总生存期。结论:RFA TACE能显著延长HCC患者的无肿瘤复发生存期及总生存期,尤其适合于直径介于3~5 cm之间的HCC患者。
英文摘要:
      Objective:To evaluate the efficacy and safety of radiofrequency ablation(RFA) plus transcatheter arterial chemoemboliza-tion(TACE) in the treatment of hepatocellular carcinoma(HCC). Methods:PubMed(1978-2013),Cochrane library(1978-2013),EMBase(1978-2013) and CNKI(1978-2013) were searched for randomized controlled trials comparing efficacy of RFA plus TACE and RFA alone for HCC. Results:According to the inclusion criteria,nine studies were selected. Meta analysis data revealed that RFA plus TACE treatment had significantly better effectiveness on 1,3,5-year overall survival rate(OR1 year=2.34,95%CI=1.54 to 3.57,P=0.000;OR3 years=1.99,95%CI=1.43 to 2.77,P=0.000;OR5 years=2.26,95%CI=1.03 to 4.95,P=0.040) and 1,3-year recurrence free sur-vival rate(OR1 year=1.74,95%CI=1.16 to 2.63,P=0.008;OR3 years=2.47,95%CI=1.61 to 3.80,P=0.000) than those of RFA alone treatment. There was no difference in terms of major complications(OR=1.24,95%CI=0.79 to 1.95,P=0.360). Subgroup analyses by tumor size showed that 1,3-year overall survival rate was significantly improved in RFA plus TACE treatment than in RFA alone treatment in patients with HCC between 3 cm and 5 cm. Conclusion:Combination of RFA with TACE can significantly improve the recurrence free survival and overall survival of patients with HCC,especially for those with HCC between 3 cm and 5 cm.
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