國家衛生研究院 NHRI:Item 3990099045/4629
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    題名: Adjuvant interferon therpay after curative therapy for hepatocellular carcinoma (HCC): A meta-analysis
    作者: Hsu, C;Shen, Y;Chen, L;Cheng, C;Hu, F;Cheng, A
    貢獻者: National Institute of Cancer Research
    摘要: Background: The role of interferon-based anti-viral therapy in chronic hepatitis C (HCV) and hepatitis B (HBV) infection is well documented. Adjuvant anti-viral therapy after curative therapy for HCC has been studied extensively but the efficacy remains unclear. The present study sought to identify predictors of efficacy of adjuvant anti-viral therapy for HCC. Methods: A systemic review of randomized trials and cohort studies was done. Data were retrieved from electronic database, including MEDLINE, PubMed, and the Cochrane library, with full articles published, and from the meeting abstracts of the American Association for the Study of Liver Disease 2005-2008. Keywords used for study retrieval included ‘anti-viral agents’, ‘hepatocellular carcinoma’, ‘liver cancer’, ‘randomized controlled trial’ and ‘cohort study’. The retrieved studies were considered eligible for meta-analysis if the studies (1) enrolled HCC patients who had undergone curative surgery or ablation therapy; (2) consisted of one or more treatment arms with interferon-based anti-viral therapy and a control arm of no anti-viral therapy; and (3) included HCC recurrence as an endpoint. The primary efficacy endpoint was improvement in recurrence-free survival (RFS) by anti-viral therapy. Trial quality was assessed by the Cochrane guidelines. Treatment effect (RFS rates of the experimental arms minus those of the control arms) was estimated by fixed effects and random effects models. Stepwise meta-regression was done to identify potential predictors of treatment effects. Results: Thirteen studies (9 randomized trials and 4 cohort studies, totally 1180 patients) were eligible for meta-analysis. Surgery and ablation therapy, including ethanol injection and radiofrequency ablation, were used in 9 and 8 studies, respectively. All studies used conventional interferon (natural or recombinant) as antiviral therapy. Overall, interferon improved the 1-year, 2-year, and 3-year RFS by 7.8%, 35.4%, and 14.0%, respectively (p all < 0.01). Higher percentage of cirrhosis and lower percentage of patients with multiple tumors were independent predictors for better treatment efficacy, in terms of improved 1-year, 2-year, and 3-year RFS. In studies using ablation therapy, interferon therapy also produced significantly better 2-year and 3-year RFS. Subgroup analysis for trials that reported virological responses in HCV patients indicated that, after controlling other factors, virological response rate had no consistent association with improvement in RFS of HCC by interferon. Conclusion: Adjuvant interferon therapy can significantly improve the RFS for HCC patients after curative therapy. The quantitative estimation of treatment efficacy and identification of predictive factors in this study will help design future clinical trials of adjuvant therapy for HCC.
    日期: 2009
    關聯: Annals of Oncology. 2009;20(Suppl. 7):91.
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0923-7534&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000268183100317
    顯示於類別:[陳立宗] 會議論文/會議摘要

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