■高强度聚焦超声(HIFU)和经动脉化疗栓塞(TACE)已被证明可有效治疗肝癌等恶性肿瘤。近年来,HIFU与TACE的结合经常被报道,但研究人员尚未就这种治疗方式的有效性和安全性达成统一结论.
■中国国家知识基础设施(CNKI),中国生物医学文献数据库,科克伦图书馆,MEDLINE,使用术语“随机对照试验(RCT)”搜索Embase数据库,“肝癌”,“经动脉化疗栓塞”,\"TACE\",“高强度聚焦超声”,\"HIFU\",“HIFU与TACE结合”,和“功效分析”。根据PICOS原则纳入研究,根据《Cochrane干预措施系统评价手册》,在随机对照试验中评估偏倚风险.RevMan5.3和Stata13用于荟萃分析。
■本研究包括6项随机对照试验,总样本量为488项。在这些研究中,图5描述了一种随机分配(RA)方法,4描述了分配序列隐藏,4使用盲法分配研究对象。荟萃分析结果显示,1年[比值比(OR)=3.13,95%CI:1.92,5.11,P<0.00001],2年(OR=3.38,95%CI:1.71,6.66,P=0.0004),5年生存率(OR=2.15,95%CI:1.02,4.55,P=0.04)接受HIFUTACE治疗的患者明显优于单独接受TACE治疗的患者。HIFU+TACE治疗患者的总有效率(TER)(OR=3.61,95%CI:2.14,6.08,P<0.00001)明显优于单纯TACE治疗患者。与单独的TACE相比,HIFU联合TACE可显著降低术后不良反应发生率(OR=0.57,95%CI:0.34,9.96,P=0.03)。
■本研究采用Meta分析,发现与单独的TACE相比,HIFU联合TACE治疗LC有较好的疗效,较高的预后和生存率,不良反应发生率较低。然而,由于研究的样本量有限,研究结果存在偏倚的风险.
UNASSIGNED: High-intensity focused ultrasound (HIFU) and transarterial chemoembolization (TACE) have been shown to be effective in the treatment of malignant tumors such as hepatocellular carcinoma. In recent years, HIFU combined with TACE has been frequently reported, but researchers have not yet reached a uniform conclusion on the efficacy and safety of this treatment modality.
UNASSIGNED: The Chinese National Knowledge Infrastructure (CNKI), China Biomedical Literature Database, Cochrane Library, MEDLINE, and Embase databases were searched using the terms \"randomized controlled trial (RCT)\", \"liver cancer\", \"transarterial chemoembolization\", \"TACE\", \"high intensity focused ultrasound\", \"HIFU\", \"HIFU combined with TACE\", and \"efficacy analysis\". Studies were included in accordance with the PICOS principle, and risk of bias was assessed in randomized controlled trials in accordance with the Cochrane Manual for Systematic Evaluation of Interventions. Rev Man 5.3 and Stata 13 were employed for meta-analysis.
UNASSIGNED: Six randomized controlled trials with a total sample size of 488 were included in this study. Of these studies, 5 described a random allocation (RA) method, 4 described allocation sequence concealment, and 4 used a blind method for the allocation of study subjects. The results of the meta-analysis showed that the 1-year [odds ratio (OR) =3.13, 95% CI: 1.92, 5.11, P<0.00001], 2-year (OR =3.38, 95% CI: 1.71, 6.66, P=0.0004), and 5-year (OR =2.15, 95% CI: 1.02, 4.55, P=0.04) survival rates (SRs) of patients treated with HIFU + TACE were significantly better than those of patients treated with TACE alone. The total effective rate (TER) of patients treated with HIFU + TACE (OR =3.61, 95% CI: 2.14, 6.08, P<0.00001) was significantly better than that of patients treated with TACE alone. Compared with TACE alone, HIFU combined with TACE significantly reduced the incidence of postoperative adverse reactions (OR= 0.57, 95% CI: 0.34, 9.96, P=0.03).
UNASSIGNED: Meta-analysis was adopted in this study, and it was found that compared with TACE alone, HIFU combined with TACE in the treatment of LC had better efficacy, higher prognosis and survival rate, and lower incidence of adverse reactions. However, due to the limited sample size of the study, there was some risk of bias in the findings.