中国原发性肝癌肝动脉化疗栓塞术和射频消融联合治疗与单独治疗的有效性和安全性比较

摘要

目的 比较原发性肝癌肝动脉化疗栓塞术(TACE)和射频消融(RFA)联合治疗与两者单独治疗的有效性和安全性.方法 通过PubMed、中国生物医学文献数据库和中国知网数据库的检索与文献筛选,纳入符合要求的临床随机对照试验的原始文献.采用荟萃(Meta)分析,比较联合治疗与单独治疗的有效性和安全性.结果 最终纳入31篇随机对照试验(2675例患者)的分析显示,联合组的原发性肝癌治疗总有效率及1年、2年和3年生存率显著高于TACE单独治疗(合并OR值为3.26~4.62),也显著高于RFA单独治疗(合并OR值为1.68~3.11).TACE与RFA联合治疗原发性肝癌的不良反应和并发症发生率与两者单独治疗的差异无统计学意义.结论 原发性肝癌TACE和RFA联合治疗效果较好,但TACE与RFA联合治疗原发性肝癌的安全性仍需进一步研究.%Objective To compare the efficacy and safety of the combined treatment of transcatheter arterial chemoembolization(TACE) and radiofrequency ablation(RFA) with TACE or RFA treatment alone in patients with primary hepatic carcinoma(PHC) in China. Methods Eligible references related to randomized controlled trials(RCTs) were searched from PubMed,Chinese Biomedical Literature database and China National Knowledge Infrastructure. Meta-analysis was used to compare the efficacy and safety of combined treatment and separate treatment. Results A total of 31 RCTs(2 675 cases) were included. It showed that the combined treatment of TACE and RFA in patients with PHC had higher total effective rates,1-year,2-year and 3-year survival rates than TACE or RFA treatment alone(combined OR were 3.26-4.62 and 1.68-3.11,respectively). There were no significant differences in the incidence of adverse events and complications between the combined treatment and TACE or RFA treatment alone. Conclusion The combined treatment ofTACE and RFA has better efficacy in patients with PHC,but its safety needs further study.