甲磺酸阿帕替尼联合TACE术治疗中晚期肝癌有效性Meta分析

余 丹, 王 镜辉, 龙 奉玺
贵州中医药大学

摘要

目的：评估甲磺酸阿帕替尼联合TACE治疗中晚期肝癌的有效性。方法：通过计算机检索PubMed、Cochrane Library、CNKI、VIP、万方数据库数据库中2015-01至2021-01关于临床中晚期肝癌通过甲磺酸阿帕替尼、TACE和（或）两者联合运用（甲磺酸阿帕替尼+TACE）的相关随机对照实验文献。提取文献资料，随后进行质量评价，纳入符合文献：将两者联用设为实验组，单纯TACE为对照组，采用RevMan 5.3软件对数据进行分析。结果：根据实验需求，筛选实验组与对照组均为随机对照研究的文献，得到符合要求文献共10篇，其中实验组309例、对照组343例，累计652例患者。通过数据分析可得，实验组相较对照组能显著改善客观缓解率(ORR)(OR=2.20,95%CI=1.60～3.04,P<0.00001)，明显提高疾病控制率(DCR)(OR=2.35,95%CI:
1.55～3.58,P<0.0001)；明显降低甲胎蛋白表达水平(AFP) (SMD=-0.89,95%CI=-1.19～-0.60,P<0.00001)。结论：在治疗中晚期肝癌时，与单纯TACE治疗肝癌相比，甲磺酸阿帕替尼与TACE联合使用在控制疾病和提高临床疗效上效果更显著。

关键词

甲磺酸阿帕替尼；肝癌；TACE；Meta分析

参考

[1] Forner,A.,Reig,M.and Bruix, J. Hepatocellular Carcinoma[J]. The Lancet,2018, 391: 1301-1314. [2] Mi, YJ, Liang, YJ, Huang, HB, et al. Apatinib (YN968D1) Reverses Multidrug Resistance by Inhibiting the Efflux Function of Multiple ATP-Binding Cassette Transporters [J]. Cancer Res,2010, 70:7981-7991. [3] Chen S, Yu W, Zhang K,et al. Comparison of the efficacy and safety of Transarterial chemoembolization with and without Apatinib for the treatment of BCLC stage C hepatocellular carcinoma[J]. BMC Cancer. 2018,18(1):1131. [4] 蔡争,宋建涛,饶航等.甲磺酸阿帕替尼片联合肝动脉化疗栓塞治疗不可切除肝细胞肝癌患者的临床研究[J].中国临床药理学 杂志,2020,36(23):3903-3906. [5] Yang Z, Chen G, Cui Y, et al. The safety and efficacy of TACE combined with apatinib on patients with advanced hepatocellular carcinoma: a retrospective study[J]. Cancer Biol Ther. 2019;20(3):321-327. [6] Liu S, Zhao G, Yu G, et al. Transcatheter arterial chemoembolization combined with low-dose apatinib in the treatment of unresectable hepatocellular carcinoma in elderly patients: Efficacy and safety[J]. J Cancer Res Ther. 2020;16(5):1165-1170. [7] Lu W, Jin XL, Yang C,et al. Comparison of efficacy between TACE combined with apatinib and TACE alone in the treatment of intermediate and advanced hepatocellular carcinoma: A single-center randomized controlled trial[J]. Cancer Biol Ther. 2017;18(6):433-438. [8] Zhu Y, Feng B, Mei L,et al. Clinical efficacy of TACE combined with Apatinib in the treatment of advanced hepatocellular carcinoma[J]. J BUON. 2019 ;24(2):608-614.[9] 曾广源,吴龚丽莉,郑文,等.阿帕替尼片联合肝动脉化疗栓塞术治疗中晚期原发性肝癌的临床研究[J].中国临床药理学杂 志,2018,34(23):2693-2696. [10] 黄锐,姚立正,李文会,等.肝动脉化疗栓塞术联合甲磺酸阿帕替尼片治疗中晚期肝癌的疗效及安全性评价[J].肿 瘤,2018,38(10):965-972. [11] 武健,尹芳,罗贯虹,等.经肝动脉化疗栓塞术联合阿帕替尼治疗中晚期原发性肝癌的效果及安全性分析[J].临床肝胆病杂 志,2018,34(04):775-778. [12] 金鑫荔,卢伟.TACE 联合阿帕替尼治疗中晚期肝细胞癌[J].中国介入影像与治疗学,2017,14(04):200-204. [13] 何健,陈晓明.2018 年肝癌 TACE 治疗研究进展[J].循证医学,2019,19(01):21-22,38.