TACE Combined with Thermotherapy for Primary Hepatic Carcinoma: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LI Zheng ^1,2 ,  MI Denghai ^1,2,3 , YANG Kehu ^1,2 , CAO Nong ¹ , TIAN Jinhui ² , MA Bin ²

1. The First Hospital of Lanzhou University, Lanzhou 730000, China; 2. Evidence Based Medicine Center of Lanzhou University, Lanzhou 730000, China;3. The Second People’s Hospital of Gansu Province, Lanzhou 730000, China;

Corresponding author：

MI Denghai, Email: mi.dh@163.com

Keywords：

Primary hepatic carcinoma; Thermotherapy; Transcatheter arterial chemoembolization (TACE); Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20120110

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with thermotherapy for primary hepatic carcinoma (PHC), and to provide references for clinical practice and research.
Methods The following databases as The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched electronically, and the other sources as supplying, such as tracing related references, were also retrieved. Besides, some unknown information was also obtained by communicating with other authors. All randomized controlled trials (RCTs) on TACE combined with thermotherapy versus TACE alone were collected. The literature was screened according to inclusive criteria, data were extracted and the quality of included studies was assessed, and then meta-analysis was conducted using RevMan 5.1 software.
Results A total of 17 RCTs with 907 patients were included. Meta-analysis showed that compared with TACE alone, TACE combined with thermotherapy had a significant difference in 1-year survival rate (HR=2.40, 95%CI 1.65 to 3.48, P lt;0.000 01), 2-year survival rate (HR=3.28, 95%CI 1.87 to 5.76, P lt;0.000 1), total effective rate (RR=1.59, 95%CI 1.42 to 1.79, P lt;0.000 1) and improvement rate of life quality (RR=1.79, 95%CI 1.42 to 2.25, P lt;0.000 1). The incidences of myelosuppression and alimentary canal reactions were lower in TACE combined with thermotherapy group than those in TACE alone group, but statistically significance was only found in myelosuppression (RR=0.79, 95%CI 0.69 to 0.92, P=0.001).
Conclusion Compared with TACE alone, TACE combined with thermotherapy can improve long-term survival rate and short-term curative effect, ameliorate the quality of life, and tend to reduce the incidence rate of side effects. But its long-term curative effect and more comprehensive safety still needs to be further verified by more large sample and high quality RCTs.

Citation： LI Zheng,MI Denghai,YANG Kehu,CAO Nong,TIAN Jinhui,MA Bin. TACE Combined with Thermotherapy for Primary Hepatic Carcinoma: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2012, 12(6): 672-678. doi: 10.7507/1672-2531.20120110 Copy

1.	Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2): 69-90.
2.	Wu DH, Liu L, Chen LH. Therapeutic effects and prognostic factors in three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma. World J Gastroenterol, 2004, 10(15): 2184-2189.
3.	Wust P, Hildebrandt B, Sreenivasa G, et al. Hyperthermia in combined treatment of cancer. Lancet Oncol, 2002, 3(8): 487-497.
4.	NHS Centre for Reviews and Dissemination. Undertaking Systematic Reviews of Research on Effectiveness: CRD’s Guidance for Carrying Out or Commissioning Reviews. CRD Report 4 (2nd Edition). York: NHS Centre for Reviews and Dissemination, 2001.
5.	狄纪君, 郭卫东, 张惠洁, 等. TACE联合热疗治疗原发性肝癌的临床观察. 临床肿瘤学杂志, 2012, 17(1): 42-46.
6.	彭杰, 胡章华, 杜驰. 动脉灌注栓塞术联合热疗治疗中晚期肝癌31例. 中国药业, 2011, 20(11): 50-51.
7.	杨金山, 魏传芳, 朱瑞霞, 等. 介入化疗栓塞术联合体外高频热疗治疗晚期肝癌临床疗效评价. 淮海医药, 2011, 29(3): 206-207.
8.	赵月红. 内生场热疗与介入化疗联合治疗中、晚期肝癌的疗效观察及护理体会. 实用临床医药杂志, 2010, 14(2): 5-6.
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10.	曹军, 汪志良, 方捷, 等. 热疗联合TACE治疗中晚期肝癌的临床观察. 肿瘤防治研究, 2009, 36(6): 520-522.
11.	付曦, 李光明, 任大成, 等. BSD2000相控阵聚焦热疗联合肝动脉化疗栓塞术治疗中晚期肝癌. 西部医学, 2009, 21(6): 923-925.
12.	马兆明, 李德凡, 张胜, 等. 热疗联合肝动脉化疗栓塞治疗原发性肝癌的临床疗效观察. 中国厂矿医学, 2009, 22(6): 655-656.
13.	郑剑霄, 吴万垠, 邓宏, 等. 介入化疗栓塞术联合体外高频热疗治疗晚期肝癌临床观察. 国际医药卫生导报, 2009, 15(16): 38-40.
14.	邹庆华, 武振明, 姜玉石, 等. 肝动脉化疗栓塞联合内生场热疗治疗原发性肝癌的临床研究. 临床肝胆病杂志, 2008, 24(4): 270-271.
15.	柳弥, 张宁玲, 李秋梅, 等. 肝动脉化疗栓塞联合深部热疗治疗原发性肝癌的临床研究. 华西医学, 2008, 23(4): 723-724.
16.	怀淑君, 杨杰, 王焰. 肝动脉化疗栓塞联合肝区病灶部位热疗治疗中晚期肝癌. 吉林医学, 2008, 29(15): 1273-1274.
17.	崔琰, 崔桂琴. 中晚期肝癌热疗结合化疗栓塞术的疗效观察. 中国医药指南, 2007, 5(11): 284-285.
18.	刘楠楠, 王杨, 闫秀欣, 等. 热疗结合介入化疗栓塞术治疗中晚期肝癌的疗效观察. 中华放射医学与防护杂志, 2006, 26(2): 161-163.
19.	孙雪飞. 热疗联合介入治疗晚期肝癌临床观察. 肿瘤学杂志, 2006, 12(2): 145-147.
20.	张涵英, 朱永平, 李波. 肝动脉化疗栓塞术加体外高频热疗治疗原发性肝癌37例. 第四军医大学学报, 2005, 26(17): 1630-1631.
21.	董柏年, 冯王琨. 热疗加栓塞化疗治疗中晚期肝癌31例临床报告. 浙江临床医学, 2002, 4(2): 113.
22.	Westermann AM, Grosen EA, Katschinski DM, et al. A pilot study of whole body hyperthermia and carboplatin in platinum-resistant ovarian cancer. Eur J Cancer, 2001, 37(9): 1111-1117.
23.	Takahashi I, Emi Y, Hasuda S, et al. Clinical application of hyperthermia combined with anticancer drugs for the treatment of solid tumors. Surgery, 2002, 131(1suppl): 78-84.
24.	米登海, 李征, 杨克虎, 等. 热放化三联疗法治疗非小细胞肺癌的Meta分析. 中国循证医学杂志, 2011, 11(11): 1262-1267.
25.	李征, 杨克虎, 米登海, 等. 进展期胃癌术后腹腔热灌注化疗有效性和安全性的系统评价. 中国循证医学杂志, 2011, 11(12): 1402-1408.
26.	李征, 米登海, 杨克虎, 等. NP化疗联合热疗治疗非小细胞肺癌的Meta分析. 甘肃医药, 2011, 30(8): 451-456.
27.	De Haas-Kock DF, Buijsen J, Pijls-Johannesma M, et al. Concomitant hyperthermia and radiation therapy for treating locally advanced rectal cancer. Cochrane Database Syst Rev, 2009, (3): CD006269.
28.	Lutgens L, van der Zee J, Pijls-Johannesma M, et al. Combined use of hyperthermia and radiation therapy for treating locally advanced cervical carcinoma. Cochrane Database Syst Rev, 2010, (1): CD006377.
29.	Bergs JW, Franken NA, Haveman J, et al. Hyperthermia, cisplatin and radiation trimodality treatment: a promising cancer treatment? A review from preclinical studies to clinical application. Int J Hyperthermia, 2007, 23(4): 329-341.
30.	范文哲, 李家平, 杨建勇, 等. 无法手术切除的肝细胞癌TACE与RFA治疗的Meta分析. 中华普通外科学文献(电子版), 2011, 5(1): 62-67.
31.	汪伟民. 动脉栓塞术联合聚焦超声治疗原发性肝癌的系统回顾及META分析. 重庆: 重庆医科大学附属第二医院, 2011.

1. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2): 69-90.
2. Wu DH, Liu L, Chen LH. Therapeutic effects and prognostic factors in three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma. World J Gastroenterol, 2004, 10(15): 2184-2189.
3. Wust P, Hildebrandt B, Sreenivasa G, et al. Hyperthermia in combined treatment of cancer. Lancet Oncol, 2002, 3(8): 487-497.
4. NHS Centre for Reviews and Dissemination. Undertaking Systematic Reviews of Research on Effectiveness: CRD’s Guidance for Carrying Out or Commissioning Reviews. CRD Report 4 (2nd Edition). York: NHS Centre for Reviews and Dissemination, 2001.
5. 狄纪君, 郭卫东, 张惠洁, 等. TACE联合热疗治疗原发性肝癌的临床观察. 临床肿瘤学杂志, 2012, 17(1): 42-46.
6. 彭杰, 胡章华, 杜驰. 动脉灌注栓塞术联合热疗治疗中晚期肝癌31例. 中国药业, 2011, 20(11): 50-51.
7. 杨金山, 魏传芳, 朱瑞霞, 等. 介入化疗栓塞术联合体外高频热疗治疗晚期肝癌临床疗效评价. 淮海医药, 2011, 29(3): 206-207.
8. 赵月红. 内生场热疗与介入化疗联合治疗中、晚期肝癌的疗效观察及护理体会. 实用临床医药杂志, 2010, 14(2): 5-6.
9. 单汉国, 谢文彪. 肝动脉化疗栓塞联合深部热疗治疗原发性肝癌的临床研究. 医学研究杂志, 2009, 38(10): 76-78.
10. 曹军, 汪志良, 方捷, 等. 热疗联合TACE治疗中晚期肝癌的临床观察. 肿瘤防治研究, 2009, 36(6): 520-522.
11. 付曦, 李光明, 任大成, 等. BSD2000相控阵聚焦热疗联合肝动脉化疗栓塞术治疗中晚期肝癌. 西部医学, 2009, 21(6): 923-925.
12. 马兆明, 李德凡, 张胜, 等. 热疗联合肝动脉化疗栓塞治疗原发性肝癌的临床疗效观察. 中国厂矿医学, 2009, 22(6): 655-656.
13. 郑剑霄, 吴万垠, 邓宏, 等. 介入化疗栓塞术联合体外高频热疗治疗晚期肝癌临床观察. 国际医药卫生导报, 2009, 15(16): 38-40.
14. 邹庆华, 武振明, 姜玉石, 等. 肝动脉化疗栓塞联合内生场热疗治疗原发性肝癌的临床研究. 临床肝胆病杂志, 2008, 24(4): 270-271.
15. 柳弥, 张宁玲, 李秋梅, 等. 肝动脉化疗栓塞联合深部热疗治疗原发性肝癌的临床研究. 华西医学, 2008, 23(4): 723-724.
16. 怀淑君, 杨杰, 王焰. 肝动脉化疗栓塞联合肝区病灶部位热疗治疗中晚期肝癌. 吉林医学, 2008, 29(15): 1273-1274.
17. 崔琰, 崔桂琴. 中晚期肝癌热疗结合化疗栓塞术的疗效观察. 中国医药指南, 2007, 5(11): 284-285.
18. 刘楠楠, 王杨, 闫秀欣, 等. 热疗结合介入化疗栓塞术治疗中晚期肝癌的疗效观察. 中华放射医学与防护杂志, 2006, 26(2): 161-163.
19. 孙雪飞. 热疗联合介入治疗晚期肝癌临床观察. 肿瘤学杂志, 2006, 12(2): 145-147.
20. 张涵英, 朱永平, 李波. 肝动脉化疗栓塞术加体外高频热疗治疗原发性肝癌37例. 第四军医大学学报, 2005, 26(17): 1630-1631.
21. 董柏年, 冯王琨. 热疗加栓塞化疗治疗中晚期肝癌31例临床报告. 浙江临床医学, 2002, 4(2): 113.
22. Westermann AM, Grosen EA, Katschinski DM, et al. A pilot study of whole body hyperthermia and carboplatin in platinum-resistant ovarian cancer. Eur J Cancer, 2001, 37(9): 1111-1117.
23. Takahashi I, Emi Y, Hasuda S, et al. Clinical application of hyperthermia combined with anticancer drugs for the treatment of solid tumors. Surgery, 2002, 131(1suppl): 78-84.
24. 米登海, 李征, 杨克虎, 等. 热放化三联疗法治疗非小细胞肺癌的Meta分析. 中国循证医学杂志, 2011, 11(11): 1262-1267.
25. 李征, 杨克虎, 米登海, 等. 进展期胃癌术后腹腔热灌注化疗有效性和安全性的系统评价. 中国循证医学杂志, 2011, 11(12): 1402-1408.
26. 李征, 米登海, 杨克虎, 等. NP化疗联合热疗治疗非小细胞肺癌的Meta分析. 甘肃医药, 2011, 30(8): 451-456.
27. De Haas-Kock DF, Buijsen J, Pijls-Johannesma M, et al. Concomitant hyperthermia and radiation therapy for treating locally advanced rectal cancer. Cochrane Database Syst Rev, 2009, (3): CD006269.
28. Lutgens L, van der Zee J, Pijls-Johannesma M, et al. Combined use of hyperthermia and radiation therapy for treating locally advanced cervical carcinoma. Cochrane Database Syst Rev, 2010, (1): CD006377.
29. Bergs JW, Franken NA, Haveman J, et al. Hyperthermia, cisplatin and radiation trimodality treatment: a promising cancer treatment? A review from preclinical studies to clinical application. Int J Hyperthermia, 2007, 23(4): 329-341.
30. 范文哲, 李家平, 杨建勇, 等. 无法手术切除的肝细胞癌TACE与RFA治疗的Meta分析. 中华普通外科学文献(电子版), 2011, 5(1): 62-67.
31. 汪伟民. 动脉栓塞术联合聚焦超声治疗原发性肝癌的系统回顾及META分析. 重庆: 重庆医科大学附属第二医院, 2011.

Chinese Journal of Evidence-Based Medicine

TACE Combined with Thermotherapy for Primary Hepatic Carcinoma: A Meta-Analysis

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