肝癌的临床管理:一个系统的审查
Ram Prasad Sinnanaidu1, Vikneshwaran Chandra Kumar2, Ranita Hisham Shunmugam3
1Gastroenterology Unit, Medical Department Universiti Malaya Medical Centre Kuala Lumpur Malaysia.
概括
肝癌治疗缺乏明确的指导方针. 皮质类固醇或UDCA是有效的第一线选择,其他药物对耐火病例显示出希望.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 免疫学 免疫学 免疫学
- 内部医学 内部医学
背景情况:
- 肝硬化症是一种罕见的疾病,已建立的治疗方案有限.
- 本系统性审查解决了为临床医生提供基于证据的治疗指导的需要.
研究的目的:
- 系统地审查现有的关于肝癌治疗的文献.
- 为了评估各种药理学药物的有效性,在管理肝脏类菌病.
主要方法:
- 在主要的医学数据库 (MEDLINE,PubMed,CINAHL,Cochrane Library,Google Scholar) 中进行了全面的文献搜索.
- 包括原始文章,详细介绍了使用药物治疗的成年肝硬化症患者的临床结果.
- 主要终点集中在治疗后的症状缓解和生化改善.
主要成果:
- 分析了涉及268名患者的34项研究的数据.
- 一线治疗用皮质类固醇的患者分别在60.4%和42.8%的患者中显示出症状和生化反应.
- 在57.5%的患者中,乌尔索西胆酸 (UDCA) 实现了完整的反应.
- 第二线疗法 (阿扎西奥普林,甲铁酸) 和第三线抗瘤坏死因子 (抗TNF) 药物在耐火病例中显示出显著的响应率.
结论:
- 目前对于肝硬性瘤治疗的证据基础质量不佳.
- 皮质类固醇和UDCA似乎是有效的第一线治疗方法.
- 类固醇节约剂和抗TNF疗法显示出对皮质类固醇耐药性肝硬化的潜力,需要进一步进行高质量的研究.
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