Network meta-analysis for efficacy and safety of TACE combined with local ablation in the treatment of unresectable primary liver cancer
- VernacularTitle:TACE联合局部消融术治疗不可切除原发性肝癌有效性与安全性的网状Meta分析
- Author:
Yuan TIAN
1
,
2
;
Guiju TANG
3
;
Bo LI
4
;
Yaling LI
2
Author Information
1. Dept. of Pharmacy，Zigong Fourth People’s Hospital，Sichuan Zigong 643000，China
2. Dept. of Pharmacy，the Affiliated Hospital of Southwest Medical University，Sichuan Luzhou 646000，China
3. Dept. of Pharmacy，Ziyang Municipal First People’s Hospital，Sichuan Ziyang 641300，China
4. Dept. of Hepatobiliary Surgery，the Affiliated Hospital of Southwest Medical University，Sichuan Luzhou 646000，China
- Publication Type:Journal Article
- Keywords:
primary liver cancer;
unresectable;
transcatheter arterial chemoembolization;
local ablation;
meta-analysis
- From:
China Pharmacy
2022;33(22):2779-2785
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To systematically evaluate the efficacy and safety of transcatheter arterial chemoembolization （TACE） combined with local ablation in the treatment of unresectable primary liver cancer （PLC）， and to provide evidence-based reference for rational clinical treatment. METHODS Retrieved from CNKI， Wanfang Data， VIP， PubMed， Embase， Cochrane Library， ClinicalTrials， Web of Science， Ovid and SinoMed， randomized controlled trial （RCT） about TACE combined with local ablation （trial group） versus TACE （control group） were collected. After screening the literature and extracting the data， the bias risk assessment tool recommended by the Cochrane System Evaluator Manual 5.1.0 was used to evaluate the quality of the included literature； Stata14.0 software was used for meta-analysis. RESULTS A total of 39 RCTs were included， including 2 294 patients， involving 6 interventions， i.e. TACE， TACE + radiofrequency ablation （RFA）， TACE + microwave ablation （MWA）， TACE + absolute ethanol injection （PEI）， TACE + cryoablation （CRA）， TACE + high-intensity ultrasound focused ablation （HIFU）， and 4 chemotherapeutic drugs， i.e. platinum， anthracycline， pyrimidine analogues， and polypeptides. The results of meta-analysis showed that in terms of objective remission rate， TACE+RFA， TACE+HIFU and TACE+MWA were higher； in terms of 1-year survival rate， TACE+PEI， TACE+HIFU and TACE+MWA were higher； in terms of 2-year survival rate， TACE+HIFU， TACE+MWA and TACE+PEI were higher； in terms of 3-year survival rate， TACE+HIFU， TACE+PEI and TACE+RFA were higher； in terms of security， TACE+MWA， TACE+RFA and TACE were 643295494@qq.com higher； there was no significant difference in the efficacy of 4 chemotherapeutic drugs in TACE+MWA （P＞0.05）. CONCLUSIONS For patients with unresectable PLC， TACE+ MWA has good efficacy and safety， which is the best combination； the 4 chemotherapeutic drugs in TACE+MWA are all effective， and suitable chemotherapeutic drugs can be selected individually.
