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中国癌症防治杂志

中国癌症防治杂志 ›› 2012, Vol. 4 ›› Issue (1): 65-70.doi: 10.3969/j.issn.1674-5671.2012.01.16

• 循证医学 • 上一篇    下一篇

肝细胞性肝癌根治性切除术后口服药物化疗效果的系统评价

  

  1. 广西柳州市工人医院普通外科；广西医科大学第一附属医院循证医学教研室；广西医科大学附属肿瘤医院肝胆外科

  • 出版日期:2012-03-25 发布日期:2012-04-16
  • 通讯作者: 游雪梅 E-mail:you_xuemei@163.com

Postoperative adjuvant oral chemotherapy for hepatocellular carcinoma：a Meta-analysis

  • Online:2012-03-25 Published:2012-04-16

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被引次数

5

摘要： 目的 评价肝细胞性肝癌（hepatocellular carcinoma，HCC）根治性切除术后口服药物化疗（oral chemotherapy，OC）对预防肿瘤复发及提高患者总生存率的疗效和安全性。方法 计算机检索Medline、Embase等数据库有关HCC术后OC治疗的随机对照试验，对纳入文献进行资料提取及质量评价，采用相对危险度（RR）及其95%可信区间（CI）表示统计效应量。结果 共纳入3个随机对照试验，合计286例患者。Meta分析结果显示：①1、3、5年复发率：辅助OC治疗组与单纯手术治疗组比较，两组差异均无统计学意义（RR=0.92，95% CI：0.26～1.35，P=0.66； RR=0.82，95% CI：0.66～1.01，P=0.06； RR=0.84，95% CI：0.71～1.01，P=0.06）。② 1、3、5年总生存率：辅助OC治疗组与单纯手术治疗组比较，两组差异亦无统计学意义（RR=1.43，95% CI：0.58～3.56，P=0.44； RR=1.39，95% CI：0.75～2.55，P=0.29； RR=1.20，95% CI：0.46～3.16，P=0.71）。③不良反应主要为恶心、呕吐、腹泻、肝功能异常和白细胞/血小板计数下降，尚未见与OC相关的感染、自身免疫性疾病或死亡报道。结论 目前的证据显示辅助OC治疗不能降低HCC患者术后复发率及提高总生存率。由于本研究纳入病例数较少，有必要开展多中心大样本的随机对照试验来进一步证实。

关键词: 肝细胞性肝癌, 口服, 系统化疗, Meta分析

Abstract:  Objective To evaluate the efficacy and safety of postoperative oral chemotherapy（OC） for patients with hepatocellular carcinoma （HCC）.Methods Sources such as MEDLINE and EMBASE were searched.All randomized trials comparing curative hepat-ic resection alone with hepatic resection plus OC  to treat HCC were identified.Risk ratios （RRs） and 95% confidence intervals （95% CIs） were calculated.Results Three randomized controlled trials involving 286 patients were included.For 1-，3-，and 5-year tumor re-currence rates，hepatic resection plus OC did not show significantly lower recurrence，with respective pooled risk ratios （RRs） of 0.92 （95% CI=0.26~1.35，P=0.66），0.82（95% CI=0.66~1.01，P=0.06），and 0.84（95% CI=0.71~1.01，P= 0.06）.Similarly，hepatic resection plus OC did not show significant differences in 1-，3-，or 5-year overall survival from resection alone（1-year survival，RR=1.43，95% CI=0.58~3.56，P=0.44；3-year survival，RR=1.39，95% CI=0.75~2.55，P=0.29；5-year survival，RR=1.20，95% CI=0.46~3.16，P=0.71）.Nausea，vomiting，diarrhea，abnormal liver function and leukocyte and/or platelet count decline were reported as side effects of OC，but these were well tolerated by most patients.No infections，autoimmune disorders or deaths related to treatment were reported.Conclu-sion Adjuvant OC appears to be ineffective for treating patients with HCC after hepatic resection，but definitive conclu-sions require further trials.

Key words: Hepatocellular carcinoma, Oral, Systemic chemotherapy, Meta-analysis