系统治疗加上HAIC与肝细胞癌的系统治疗:系统性审查和元分析
Donghai Lu1, Han Li1, Pengfei Sun1,2
1Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China.
International journal of surgery (London, England)
|March 27, 2025
概括
将肝动脉输液化疗 (HAIC) 与全身治疗相结合,显著改善了肝细胞癌 (HCC) 患者的生存结果. 这种方法提供了生存益处与可管理的毒性,建立了先进的HCC治疗的新基准.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 肝细胞癌 (HCC) 是一个主要的全球健康问题.
- 肝动脉输液化疗 (HAIC) 在与HCC的全身疗法相结合时显示出有前途.
- 支持高级HCC综合治疗方法的证据有限.
研究的目的:
- 评估将HAIC与HCC的全身治疗相结合的疗效和安全性.
- 为先进的HCC治疗建立一个生存基准.
- 分析与联合治疗相关的生存益处和不良事件.
主要方法:
- 从1990年1月到2024年7月,在PubMed,Embase,Cochrane图书馆和Web of Science进行了系统的文献搜索.
- 数据使用固定或随机效应模型汇总,报告危险比率 (HRs) 和风险比率 (RRs) 以95%的置信区间 (CI).
- 进行了元回归,子组,预后因素,相关性和试验顺序分析.
主要成果:
- 有3070名参与者的17项试验表明,HAIC和全身疗法的联合治疗显著改善了整体存活率 (OS) 和无进展存活率 (PFS).
- 客观反应率 (ORR) 和疾病控制率 (DCR) 也在组合治疗组中优越.
- 虽然不良事件是可以管理的,但子组分析表明,在没有门静脉瘤血栓症的患者中,潜在的益处缺乏.
结论:
- 将HAIC与全身疗法的整合为可控毒性HCC患者提供了显著的生存优势.
- 结合方法可能会为先进的HCC建立新的生存基准.
- 需要进一步的研究来规范HAIC与一线全身治疗的整合.
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