| Backgroud:Primary hepatic carcinoma(PHC)is a malignant epithelial tumor that occurs in the hepatocytes or intrahepatic bile duct cells,and is one of the most common malignant tumor in the world.This disease ranks sixth in the incidence of malignant tumors in the world,and ranks fourth morbidity and third mortality in China,which seriously threatens people’s lives and health.Because its early symptoms are not obvious,the majority of patients have been in the late stage of tumor development,and have lost the opportunity of surgery.TACE is recognized as the first choice for PHC patient who cannot do operation.Conventional chemotherapy has limited effect on PHC.S-1,a mixed preparation of tegafur,gimeracil and Oteracil,had showed certain curative effect on PHC.In recent years,TACE combined with S-1 as non-surgical treatment of PHC have been applied to clinical.Therefore,it is necessary to analyze the clinical efficacy of the combined treatment of these two methods with Meta,which can provide evidence-based medicine for clinical work.Object: To assess the efficacy and safety of transcatheter arterial chemoebolization(TACE)combined with S-1 in the treatment of primary hepatic carcinoma(PHC),and to provide evidence-based medicine for clinical work.Methods: Clinical data involved in PHC treated with TACE and S-1 were collected from computer literature searching until February 2018,with carried out in Pub Med,Embase,Cochrane and China National Knowledge Internet(CNKI),etc.Quality evaluation was assessed by Jadad and risk of bias table.Rev Man 5.3 software,recommended by the Cochrane Collaboration,was used for meta-analysis.Publication bias was assessed via funnel plot,Begg and Egger.Results: 9 clinical studies including in 569 cases were admitted in our study including 8randomized controlled trials and 1 cohort study.The objective response rate and disease control rate of TACE combined with S-1 treatment of PHC respectively were 69.8% and89.9%,which were superior to TACE alone 42.9% and 65.6%,P < 0.05.The one-year,two-year and three –year survival rates of TACE combined with S-1 treatment of PHC were80%,47.9% and 36.5%,comparing with TACE alone(53.5%,24.1% and 14.1%,P<0.05),combination with S-1 can improve one-year,two-year and three –year survival rates of PHC.The most common adverse events were bone marrow suppression,nausea,vomiting,abdominal pain,fever.Excepting nausea and vomiting,the differences of other adverse reactions were statistically significant(P > 0.05).It is improved after treatment of disease.There is no serious adverse reaction.Conclusion: The results of the Meta analysis show that S-1 combined with TACE in the treatment of primary hepatic carcinoma,comparing with TACE alone,can improve the clinical effect and survival rate with tolerable adverse reactions.Due to the limited clinical literature,it is bound to affect the strength of the results,and more high quality randomized clinical studies are needed to further explore the conclusion. |
