摘要
目的评估T-T-P对比T-P治疗uHCC的疗效和安全性。方法对PubMed、EmBase、Web of Science、Cochrane Library中自建库至2023年12月底的文献进行全面检索。根据纳入及排除标准选择纳入研究并进行质量评价,采用标准化方案进行数据提取和筛选。使用Stata17.0软件对生存期、肿瘤反应、不良反应等结局指标进行Meta分析。结果9项研究共计855例uHCC患者纳入Meta分析。结果显示,与T-P组相比,T-T-P治疗方案能延长OS(HR=0.49,95%CI:0.40~0.60,I^(2)=0,P=0.804)和PFS(HR=0.60,95%CI:0.50~0.71,I^(2)=7%,P=0.376);提高ORR(RR=2.00,95%CI:1.69~2.37,I^(2)=0,P=0.937)以及DCR(RR=1.40,95%CI:1.27~1.54,I^(2)=3%,P=0.407)。3/4级不良反应在T-T-P组发生率更高,包括丙氨酸转氨酶升高、疲劳、恶心或呕吐。结论T-T-P的联合治疗方案优于T-P方案,其改善了不可切除肝细胞癌患者的OS、PFS、ORR和DCR,并且不良反应可控。
Objective To evaluate the efficacy and safety of T-T-P versus T-P in the treatment of uHCC.Methods The literatures in PubMed,EmBase,Web of Science and Cochrane Library from inception to the end of Dec.2023 were comprehensively searched.Inclusion studies were selected and quality evaluated according to inclusion and exclusion criteria,and data extraction and screening were performed using standardized protocols.Meta-analysis of outcome indicators such as survival,tumor response and adverse reactions was performed using Stata 17.0 software.Results A total of 855 uHCC patients from 9 studies were included in the Meta-analysis.The results showed that T-T-P regimen prolonged OS(HR=0.49,95%CI:0.40-0.60,I^(2)=0,P=0.804)and PFS(HR=0.60,95%CI:0.50-0.71,I^(2)=7%,P=0.376)compared with T-P group.ORR(RR=2.00,95%CI:1.69-2.37,I^(2)=0,P=0.937)and DCR(RR=1.40,95%CI:1.27-1.54,I^(2)=3%,P=0.407)were increased.Grade 3/4 adverse events were more common in the T-T-P group and included elevated alanine aminotransferase,fatigue,nausea,or vomiting.Conclusion The T-T-P combination regimen was superior to the T-P regimen,which improved OS,PFS,ORR,and DCR in patients with unresectable hepatocellular carcinoma,and the adverse effects were controllable.
作者
李钊
汪杰
赵敬兵
周国俊
吴建林
冷政伟
LI Zhao;WANG Jie;ZHAO Jingbing;ZHOU Guojun;WU Jianlin;LENG Zhengwei(Department of Hepato-Biliary-PancreaseⅡ,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)
出处
《胃肠病学和肝病学杂志》
2025年第2期199-207,共9页
Chinese Journal of Gastroenterology and Hepatology
基金
四川省医学科研课题计划(S20050)
北京医卫健康公益基金会(XBZQ-23007)。
