| 王俊镔,张晶,卢冬彦,等.阿帕替尼联合经导管肝动脉灌注化疗栓塞治疗中晚期肝癌临床研究的系统评价[J].安徽医药,2019,23(12):2504-2510. |
| 阿帕替尼联合经导管肝动脉灌注化疗栓塞治疗中晚期肝癌临床研究的系统评价 |
| Meta?analysis of the combination of transarterial chemoembolization and apatinib for the treatment of intermediated or advanced hepatocellular carcinoma |
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| DOI：10.3969/j.issn.1009?6469.2019.12.044 |
| 中文关键词: 肝肿瘤 化学栓塞，治疗性 肝动脉 血管内皮生长因子类 基质金属蛋白酶 9 阿帕替尼 Meta分析 |
| 英文关键词: Liver neoplasms Chemoembolization,therapeutic Hepatic artery Vascular endothelial growth factors Matrix metalloproteinase 9 Apatinib Meta?analysis |
| 基金项目:广东省中医药局科研项目(20164011) |
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| 中文摘要: |
| 目的分析比较阿帕替尼联合经导管肝动脉灌注化疗栓塞(TACE)和单独应用 TACE治疗中晚期原发性肝癌的临床疗效。方法利用计算机检索建库年至 2018年 11月间 PubMed、Cochrane Library、Embase、中国知网(CNKI)、万方数据库、维普期刊及中国生物医学文献数据库(CBM)等数据库中关于比较阿帕替尼联合 TACE与单纯 TACE治疗原发性肝癌病人临床疗效及预后对照试验的相关文献报道。应用 Review Manager(Version 5.3)软件，按照 Cochrane协作网推荐的方法，对符合纳入标准的文献报道结果进行 meta分析。结果本研究共纳入 10项研究(8项随机对照试验及 2项队列研究)，共包括原发性肝癌病人 716例。阿帕替尼联合 TACE治疗中晚期原发性肝癌的客观缓解率(ORR)和疾病控制率(DCR)(ORORR＝4.23，95%CI:2.19~ |
| 英文摘要: |
| Objective This meta?analysis was to comprehensively compare the effectiveness of the combination of Apatinib andTACE with that of TACE alone for intermediated or advanced hepatocellular carcinoma(HCC).Methods Using computer retrieval database construction between November 2018 and PubMed，Cochrane Library，Embase，China National Knowledge Internet(CNKI)、 Wan fang database、VIP journal and Chinese Biomedical Literature database(CBM)were used for searching literatureson the comparison of the effectiveness of the combination of Apatinib and TACE with that of TACE alone for the treatment of HCC. Review Manager(version 5.3)software from Cochrane Collaboration was used for this meta?analysis.Results Eight randomized controlled trials and two cohort study were included in this meta?analysis and totally included 716 HCC patients.The results of the meta?analysis showed that the objective response rate and disease control rate(ORORR＝4.23，95%CI:2.19~8.18，P＜0.01；ORDCR＝ 5.38，95%CI:3.17~9.13，P＜0.01)and 6?month，1?year，2?year overall survival(OR6?m＝2.88，95%CI:1.77?4.69，P＜0.01；OR1?Y＝ 2.25，95%CI:1.32?3.84，P＜0.01；OR2?Y＝3.10，95%CI:1.31?7.34，P＝0.01)of the combination of Apatinib and TACE were much better than that of TACE alone for the treatment of HCC.The level of vascular endothelial growth factor(VEGF)［MDVEGF＝-87.32， 95%CI:-109.32?-65.33，P＜0.01］and matrix metalloproteinase?9(MMP?9)［MDMMP?9＝-536.68，95%CI:-622.79?-450.57，P＜ 0.01］were markedly decreased and which was statistically different to control group.The incidence of Hand?foot syndrome，diarrhea， hypertension，proteinuria，rash，pruritus were higher in the Apatinib with TACE group than in the TACE alone group.Conclusion The combination of Apatinib and TACE was associated with superior early treatment response and survival in comparison TACEmonotherapy for patients with intermediated or advanced HCC. |
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