摘要目的 综合评价奥曲肽对晚期肝癌患者生存期的影响.方法 检索各种电子数据库,对所有关于奥曲肽治疗晚期肝癌的随机对照试验进行Meta分析.结果 共纳入5项随机对照临床试验,579例晚期肝癌患者.Meta分析显示奥曲肽治疗对于患者的6、12和24个月生存率无显著影响(6个月:OR值1.69,95%CI 0.89～3.21,P=0.11;12个月:OR值2.41,95%CI 0.83～6.93,P=0.10;24个月:OR值0.58,95%CI 0.28～1.17,P=0.13).敏感性分析中分别剔除了空白对照的研究、排除生长抑素受体阴性患者的研究、患者生存期较短的研究和随访期较短的研究,结果均显示奥曲肽治疗对于患者的6、12个月生存率均无显著影响.有2项敏感性分析显示奥曲肽治疗组24个月生存率显著低于对照组(OR值0.51,95%CI 0.27～0.98,P=0.04).结论 奥曲肽并不能延长晚期肝癌患者的生存期,不应推荐用于晚期肝癌的治疗.

abstractsObjective To evaluate the effect of octreotide on the survival of patients with advanced hepatocellular carcinoma(HCC).Methods Electronic databases searches were conducted.Meta-analysis of all randomized controlled trials (RCTs) comparing octreotide versus placebo or no treatment was performed.Results Five RCTs including 579 patients with HCC wers assessed.Meta-analysis of the five studies showed that octreotide had no significant effect on the 6,12 and 24 months survival rates of the patients(6months:OR=1.69,95%CI 0.89-3.21,P=0.11;12 months:OR=2.41,95%CI 0.83-6.93,P=0.10;24months:OR=0.58,95%CI 0.28-1.17,P=0.13).To perform the sensitivity analysis,the blank study,the trial detecting somatostatin receptor expression,the study with short survival or the two trials with short follow-up intervals were excluded,and the results also showed that the octreotide treatment had no significant effect on the 6 and 12 months survival rates.A sensitivity analysis based on two trials indicated that the 24months survival rate of the octreotide group was even lower than that of the control group(OR=0.51,95% CI0.27-0.98,P=0.04).Conclusions This Meta-analysis demonstrates that octreotide could not improve the survival of patients with advanced HCC.The administration of octreotide should not be recommended for the treatment of advaneed HCC.