治疗中期肝细胞癌疗法的有效性:系统性审查和网络元分析
Shaoqi Zong1,2,3, Yifan Yang1,2,3, Zifei Yin4
1Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Frontiers in immunology
|July 24, 2025
概括
网络分析发现,七种疗法比标准TACE提高了中期肝细胞癌 (HCC) 的整体存活率. 没有一种疗法改善了无进展的存活率,但组合疗法对特定患者群体有希望.
科学领域:
- 肝胆瘤学 肝胆瘤学
- 干预性放射学 干预性放射学
- 医学瘤学 医学瘤学
背景情况:
- 跨动脉化学栓塞 (TACE) 是中期肝细胞癌 (HCC) 的标准治疗方法.
- 选择最佳疗法仍然具有挑战性,因为不同治疗方案的疗效不同.
- 网络元分析 (NMA) 用于同时比较多种疗法.
研究的目的:
- 为了比较各种治疗方案对中期HCC的疗效.
- 与TACE相比,以更高的整体存活率 (OS) 和无进展存活率 (PFS) 确定治疗方法.
- 使用网络元分析对不同治疗方法的疗效进行排名.
主要方法:
- 在2024年3月15日之前进行了全面的文献审查.
- 从38项涉及10,972名患者的研究中提取了有效性结果 (OS和PFS).
- 随机效应的NMA和子组分析是基于瘤特征和病毒病因学的.
主要成果:
- 与TACE单独治疗相比,七种疗法证明了改善的生存状况.
- 像TACE加微波切除和TACE加肝切除这样的组合显示出显著的OS益处.
- 没有治疗比单独TACE显著改善PFS;然而,肝切除加TACE对HBV感染患者是最佳的.
结论:
- 与TACE相比,一些治疗策略为中期HCC患者提供了改善的整体存活率.
- 组合疗法,特别是那些涉及切除或切除的疗法,显示出希望.
- 进一步的研究可能会根据个体患者的因素和病毒病因来改进治疗选择.
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