Efficacy Of Hepatic Arterial Chemoembolization Combined With Sorafenib In The Treatment Of Advanced Hepatocellular In Carcinoma China:Meta Analysis

ObjectPrimary hepatocellular carcinoma is one of the most common malignant tumors in China.The pathogenesis is concealed,the symptoms are not obvious,and the clinical diagnosis is mostly in the middle and late stage.Therefore,the optimal surgical treatment time is lost.For patients who cannot be operated,the preferred treatment plan is the first choice.Embolization for hepatic artery chemotherapy.However,clinically,there was no significant improvement in survival after TACE monotherapy,which was considered to be related to overexpression of vascular endothelial growth factor after TACE.Sorafenib is a multi-target,multi-enzyme inhibitor with anti-tumor neovascularization.Therefore,for patients with advanced primary hepatocellular carcinoma,combined with sorafenib in TACE treatment is a reasonable and feasible treatment.This study aims to provide further guidance for clinical treatment by meta-analysing the analysis of TACE combined with the efficacy of sorafenib.MethodUsing computer search HowNet database,Wanfang database,Weipu database,Baidu library,PubMed database,Google Scholar,Springer Link,Cochrane and other databases,as of June 2018,about TACE combined with sorafenib for observation group and TACE The single treatment was a clinical controlled trial of Chinese advanced primary hepatocellular carcinoma in the control group.Data extraction and quality evaluation were carried out on the included literature,and statistics were performed using RevMan 5.1.0 software.ResultThis meta-analysis included 14 relevant clinical studies involving 1022 patients with well-diagnosed Chinese patients with advanced hepatocellular carcinoma.Meta-analysis showed that TACE combined with sorafenib significantly improved short-term and long-term survival in patients with advanced hepatocellular carcinoma in China.Short-term survival included an increase in clinical control rate(OR _{after 1 months} 3.28,P=0.0005;OR _{after 3 months}2.30,P=0.010;OR _{after 6months}4.12,P<00001),improvement in quality of life improvement?OR2.76,P=0.0001?,decreased VEGF levels?OR-1.99,P=0.002?and long-term survival including 6-month overall survival?OR 2.66,P=0.001?,1-year overall survival?OR 3.31,P<0.00001?,3-year overall survival?OR 4.33,P=0.0002?,5-year overall survival?OR 3.28,P=0.003?and median survival was extended.Conclusion1.For patients with advanced hepatocellular carcinoma in China,hepatic arterial chemoembolization combined with sorafenib can significantly improve the clinical control rate,survival quality improvement rate,survival rate and median survival time.2.Transcatheter arterial chemoembolization combined with sorafenib significantly reduced serum VEGF levels.3.For patients with advanced hepatocellular carcinoma in China,hepatic arterial chemoembolization combined with sorafenib is superior to single-use hepatic arterial chemoembolization in both short-term and long-term survival.4.However,due to the relatively small number of studies included in this paper,the credibility of the results of the systematic evaluation of this study may be affected.More large randomized controlled trials and long-term follow-up are needed to further confirm.