选择性内放疗与索拉非尼治疗中晚期肝细胞癌的疗效和安全

StephenW

Efficacy and safety of selective internal radiotherapy versus sorafenib for intermediate-locally advanced hepatocellular carcinoma: a systematic review and meta-analysis
Jingwen Zou, Weiliang Zhu, Hui Meng, Peng Luo ORCID Icon & Jian Zhang ORCID Icon
Received 17 Sep 2018, Accepted 11 Jan 2019, Accepted author version posted online: 16 Jan 2019, Published online: 25 Jan 2019

    Download citation https://doi.org/10.1080/17474124.2019.1570135



ABSTRACT

Background: Sorafenib (SOR) is recommended for locally advanced and metastatic hepatocellular carcinoma (HCC), but the tolerability of SOR is unsatisfactory. Selective internal radiotherapy (SIRT) has shown efficacy in intermediate-locally advanced HCC patients. This meta-analysis aimed to compare the efficacy and safety of SIRT and SOR in the treatment of intermediate-locally advanced HCC.

Methods: We systematically searched the PubMed, Embase, Cochrane Library and Web of Science databases for eligible studies. The endpoints evaluated included the overall survival (OS), disease control rate (DCR), objective response rate (ORR) and grade≥3 adverse events (AEs).

Results: Six studies were included in this analysis. The OS was similar between the two groups (HR 1.06, 95%CI 0.93–1.20; P = 0.40). There was no difference in the DCR between the two groups (RR 1.13, 95%CI 0.87–1.46; P = 0.35). However, the ORR in the SIRT group was significantly higher than that in the SOR group (RR 4.10, 95%CI 1.92-8.76; P = 0.0003). The incidence rate of grade≥3 AEs was higher in the SOR group.

Conclusions: In patients with intermediate-locally advanced HCC, SIRT and SOR result in similar survival rates. The improved toxicity profile of SIRT may help when choosing between the two treatments.
KEYWORDS: Radioembolization, intra-arterial treatment, targeted therapy, TARE, vascular invasion

StephenW

选择性内放疗与索拉非尼治疗中晚期肝细胞癌的疗效和安全性：系统评价和荟萃分析
邹景文，朱伟良，孟辉，彭洛ORCID图标和张健ORCID图标
收到的2018年9月17日，接受2019年1月11日，接受作者版本在线发布：2011年1月16日，在线发布：2011年1月25日

    下载引文https://doi.org/10.1080/17474124.2019.1570135



抽象

背景：索拉非尼（SOR）推荐用于局部晚期和转移性肝细胞癌（HCC），但SOR的耐受性不令人满意。选择性内部放疗（SIRT）已经在中度 - 局部晚期HCC患者中显示出疗效。这项荟萃分析旨在比较SIRT和SOR治疗中度 - 局部晚期HCC的疗效和安全性。

方法：我们系统地搜索PubMed，Embase，Cochrane图书馆和Web of Science数据库进行符合条件的研究。评估的终点包括总生存期（OS），疾病控制率（DCR），客观反应率（ORR）和≥3级不良事件（AE）。

结果：该分析包括六项研究。两组的OS相似（HR 1.06,95％CI 0.93-1.20; P = 0.40）。两组之间的DCR无差异（RR 1.13,95％CI 0.87-1.46; P = 0.35）。然而，SIRT组的ORR显着高于SOR组（RR 4.10,95％CI 1.92-8.76; P = 0.0003）。 SOR组的≥3个AE的发病率较高。

结论：在中度 - 局部晚期HCC患者中，SIRT和SOR导致相似的存活率。当在两种治疗之间进行选择时，SIRT的改善的毒性特征可能有所帮助。
关键词：放射性栓塞，动脉内治疗，靶向治疗，TARE，血管侵犯