摘要
目的对射频消融联合经导管动脉化疗栓塞治疗原发性肝癌的系统评价/Meta分析进行再评价。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science数据库,检索截止时间为2022年12月31日,搜索射频消融联合经导管动脉化疗栓塞治疗原发性肝癌的系统评价/Meta分析。应用AMSTAR 2量表、PRISMA声明和GRADE分级系统对纳入文献的报告质量、方法学质量和证据级别进行再评价。结果共纳入13篇系统评价/Meta分析,发表年份为2011年-2022年。AMSTAR 2量表评价结果显示,4篇为低质量,余均为极低质量,无中、高质量系统评价/Meta分析。PRISMA声明评价结果显示,9篇文献的评分为15~21分,存在一定的报告缺陷,仅4篇报告相对完整。GRADE系统对9个临床结局指标75个证据体的评价结果显示,无高等证据质量,中等证据质量占29%,低等证据质量占32%,极低等证据质量占39%。结论射频消融联合经导管动脉化疗栓塞可提高原发性肝癌患者1年、3年总生存率,证据质量等级为中等;但其对5年总生存率、无复发生存率、并发症的影响以及是否对直径3~5 cm的肝细胞癌患者更有效,仍需更多高质量的临床研究及系统评价加以验证。
Objective To overview the systematic reviews/meta-analyses of radiofrequency ablation combined with transcatheter arterial chemoembolization for primary liver cancer.Methods We searched China National Knowledge Infrastructure,Wanfang,Chongqing VIP,SinoMed,PubMed,Embase,and Web of Science databases using computers,with a search deadline of December 31,2022 for systematic reviews/meta-analyses of radiofrequency ablation combined with transcatheter arterial chemoembolization for primary liver cancer.The AMSTAR 2 scale,PRISMA statement,and GRADE grading system were used to evaluate the reporting quality,methodological quality,and evidence level.Results A total of 13 systematic reviews/meta-analyses were included,published from 2011 to 2022.The evaluation results of the AMSTAR 2 scale showed that 4 systematic reviews/meta-analyses were of low quality,while the rest were of extremely low quality,without medium to high quality systematic reviews/meta-analyses.The evaluation results of PRISMA statement showed that the scores of 9 systematic reviews/meta-analyses were 15-21,with certain reporting defects,and only 4 were relatively complete.The GRADE system evaluation of 75 evidence bodies for 9 clinical outcome indicators showed that there was no high quality of evidence,with medium quality accounting for 29%,low quality accounting for 32%,and extremely low quality accounting for 39%.Conclusions Radiofrequency ablation combined with transcatheter arterial chemoembolization can improve the 1-year and 3-year overall survival rates of patients with primary liver cancer with medium quality of evidence.However,its impact on 5-year overall survival rate,recurrence-free survival rate,complications,and whether it is more effective for hepatocellular carcinoma with a diameter of 3-5 cm still require more high-quality clinical research and systematic evaluation to verify.
作者
孙童
胡世平
王馨
李峰
冉云
SUN Tong;HU Shiping;WANG Xin;LI Feng;RAN Yun(Beijing University of Chinese Medicine,Beijing,100029,P.R.China;Department of Hepatology,Shenzhen Hospital(Longgang),Beijing University of Chinese Medicine,Shenzhen,Guangdong 518100,P.R.China;Department of Dermatology,the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha,Hunan 410000,P.R.China)
出处
《华西医学》
CAS
2023年第8期1211-1218,共8页
West China Medical Journal
基金
国家自然科学基金(81973733)
深圳市科技计划项目(JCYJ20220530172804010)。
关键词
肝癌
射频消融
经导管动脉化疗栓塞
系统评价再评价
Liver cancer
radiofrequency ablation
transcatheter arterial chemoembolization
overview of systematicreviews
作者简介
通信作者:冉云,Email:35540785@qq.com。
