Sirolimus-based immunosuppression in liver transplantation for hepatocellular carcinoma: A meta-analysis
Sirolimus-based immunosuppression in liver transplantation for hepatocellular carcinoma: A meta-analysis
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基于西罗莫司的免疫抑制治疗肝细胞癌肝移植：一项荟萃分析
DOI：
10.1002/lt.22441
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发表时间：
2012-01-01
影响因子：
4.6
通讯作者：
He, Xiaoshun
中科院分区：
文献类型：
--
作者：
Liang, Wenhua;Wang, Dongping;He, Xiaoshun
西罗莫司(SRL)是一种具有抗肿瘤作用的新型免疫抑制剂。我们进行了一项荟萃分析，以确定在移植前诊断为肝细胞癌的患者中，SRL是否可以提高患者的存活率和降低肿瘤复发的风险。我们在数据库中搜索对照临床试验，评估SRL对肝移植受者肝移植前肝细胞癌的存活率和肿瘤益处。这项研究包括五项研究，共有2950名参与者。与非SRL方案相比，基于SRL的方案可提高1[优势比(OR)=4.53，95%可信区间(95%CI)=2.31~8.89]、3(OR=1.97，95%CI=1.29~3.00)和5年(OR=2.47，95%CI=1.72~3.55)的总生存率。综合结果显示，与非SRL方案相比，基于SRL方案的肿瘤复发率降低(OR=0.42，95%CI=0.21~0.83)。在移植后主要并发症的发生率方面，两组之间没有显著差异。总之，SRL总体上是安全的，并延长了肝移植受者肝移植前肝细胞癌患者的生存时间。《肝脏移植》18：6269,2012。(C)2011年AASLD。
Sirolimus (SRL) is a novel immunosuppressant with antitumor properties. We performed a meta-analysis to determine whether SRL can improve patient survival and decrease the risks of tumor recurrence in patients with a pretransplant diagnosis of hepatocellular carcinoma (HCC). We searched databases for controlled clinical trials assessing the survival and oncological benefits of SRL for liver transplant recipients with pretransplant HCC. Five studies with a total of 2950 participants were included in this study. In comparison with SRL-free regimens, SRL-based regimens improved overall survival at 1 [odds ratio (OR) = 4.53, 95% confidence interval (95% CI) = 2.31-8.89], 3 (OR = 1.97, 95% CI = 1.29-3.00), and 5 years (OR = 2.47, 95% CI = 1.72-3.55). The pooled results showed that in comparison with SRL-free regimens, SRL-based regimens decreased tumor recurrence (OR = 0.42, 95% CI = 0.21-0.83). No significant differences in the frequencies of episodes of major posttransplant complications were observed between the groups. In conclusion, SRL is generally safe and prolongs patient survival in liver transplant recipients with pretransplant HCC. Liver Transpl 18:6269, 2012. (C) 2011 AASLD.