跨动脉 (化疗) 栓塞与结直肠癌肝脏转移的全身化疗相比
Mateusz J Swierz1,2, Dawid Storman1, Jerzy W Mitus3
1Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland.
The Cochrane database of systematic reviews
|August 9, 2024
概括
超动脉化学栓塞 (TACE) 可能会降低由结直肠癌引起的肝转移的死亡率,但证据非常不确定. 需要更多的研究来比较TACE和平淡的跨动脉栓塞 (TAE) 与全身化疗.
科学领域:
- 肝胆瘤学 肝胆瘤学
- 干预性放射学是干预性的放射学.
- 医学瘤学 医学瘤学
背景情况:
- 肝转移是常见的,治疗后生存时间有限.
- 跨动脉化学栓塞 (TACE) 和平淡的跨动脉栓塞 (TAE) 通过肝动脉向肝脏瘤.
- 系统化疗 (例如,FOLFOX,FOLFIRI) 是结直肠癌肝转移的标准治疗方法.
研究的目的:
- 为了比较TACE/TAE的疗效和安全性与不可切除的结直肠癌肝转移的全身化疗.
主要方法:
- 随机临床试验的系统审查.
- 搜索了多个数据库,直到2024年4月.
- 主要结局:全因死亡率,总体存活率,不良事件. 二次结果:癌症死亡率,生活质量,无进展生存率,瘤反应.
主要成果:
- 三项试验 (234名参与者) 将TACE与全身化疗进行比较;没有试验比较TAE.
- TACE可能会降低死亡率 (非常低的确定性证据).
- 对TACE对整体存活率,不良事件,生活质量,无进展存活率和瘤反应的影响的证据非常不确定.
结论:
- 将TACE与结直肠癌肝转移的全身化疗进行比较的证据确定性非常低.
- 目前尚不确定TACE是否在死亡率,存活率,不良事件,生活质量,无进展存活率或瘤反应方面提供好处.
- 没有试验评估TAE与全身化疗;需要更多高质量的随机试验.
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