Comparing the efficacy and safety of local-regional treatments for hepatocellular carcinoma with portal/hepatic vein tumor thrombosis in China: a network meta-analysis of randomized controlled trials.

Q2 Medicine

Journal of Buon Pub Date : 2021-09-01

Qi-Qiao Wu, Hong Gao, Shi Suo Du, Yi Xing Chen, Yong Hu, Ping Yang, Jia Zhou Hou, Zhao Chong Zeng

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引用次数: 0

Abstract

Purpose: To assess the efficacy and safety of different peri-operative regimens using the network meta-analysis for hepatocellular carcinoma (HCC) with portal/hepatic vein tumor thrombosis. The interested modalities included neoadjuvant three-dimensional radiotherapy (3D-CRT), post-operative intensity modulated radiation therapy (IMRT), post-operative transarterial chemoembolization (TACE), 3DCRT plus TACE and surgery alone.

Methods: PubMed and Cochrane Library electronic databases were systematically searched for eligible studies published up to March 2021. Data related to treatment efficacy including overall survival (OS) and disease-free survival (DFS) were extracted and compared using a Bayesian approach. Adverse events (AEs) were assessed and compared.

Results: Five studies published between 2009 and 2021 were enrolled in this network meta-analysis. The comparison showed that surgery with IMRT ranks relatively higher in prolonging OS in advanced HCC patients, followed by neoadjuvant 3DCRT and surgery plus TACE. Neoadjuvant 3DCRT and postoperative IMRT appear to be better choices than 3DCRT plus TACE in terms of OS. IMRT, TACE and neoadjuvant 3DCRT group were all superior to surgery alone in terms of DFS. The rate of AEs did not differ significantly.

Conclusions: Adjuvant IMRT showed more favorable treatment responses compared to other regimens in HCC patients as a peri-operative regimen.

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比较中国门静脉/肝静脉肿瘤血栓形成肝癌局部-区域治疗的疗效和安全性:一项随机对照试验的网络meta分析

目的:通过网络meta分析，评价不同围手术期方案对肝细胞癌合并门静脉/肝静脉肿瘤血栓形成的疗效和安全性。感兴趣的方式包括新辅助三维放疗(3D-CRT)，术后调强放疗(IMRT)，术后经动脉化疗栓塞(TACE)， 3DCRT加TACE和单独手术。方法:系统检索PubMed和Cochrane图书馆电子数据库，检索截至2021年3月发表的符合条件的研究。与治疗疗效相关的数据包括总生存期(OS)和无病生存期(DFS)，并使用贝叶斯方法进行比较。对不良事件(ae)进行评估和比较。结果:2009年至2021年间发表的五项研究纳入了该网络荟萃分析。比较发现，在延长晚期HCC患者OS方面，手术加IMRT相对较高，其次是新辅助3DCRT和手术加TACE。在OS方面，新辅助3DCRT和术后IMRT似乎比3DCRT + TACE更好。在DFS方面，IMRT、TACE和新辅助3DCRT组均优于单纯手术组。ae发生率无显著性差异。结论:作为HCC患者围手术期方案，辅助IMRT比其他方案显示出更有利的治疗反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Buon 医学-肿瘤学

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： JBUON aims at the rapid diffusion of scientific knowledge in Oncology. Its character is multidisciplinary, therefore all aspects of oncologic activities are welcome including clinical research (medical oncology, radiation oncology, surgical oncology, nursing oncology, psycho-oncology, supportive care), as well as clinically-oriented basic and laboratory research, cancer epidemiology and social and ethical aspects of cancer. Experts of all these disciplines are included in the Editorial Board. With a rapidly increasing body of new discoveries in clinical therapeutics, the molecular mechanisms that contribute to carcinogenesis, advancements in accurate and early diagnosis etc, JBUON offers a free forum for clinicians and basic researchers to make known promptly their achievements around the world. With this aim JBUON accepts a broad spectrum of articles such as editorials, original articles, reviews, special articles, short communications, commentaries, letters to the editor and correspondence among authors and readers. JBUON keeps the characteristics of its former paper print edition and appears as a bimonthly e-published journal with continuous volume, issue and page numbers.