中文摘要：

[目的]比较经肝动脉插管化疗栓塞治疗（TACE）与对症治疗或经静脉化疗对无法手术切除肝癌的临床疗效.[方法]计算机检索MEDLINE （1980～2010年）、EMBASE （1989～2010年）、互联网上注册临床试验数据库、中国生物医学文献数据库（1980～2010年）.纳入TACE和对症治疗或经静脉化疗治疗无法手术切除肝癌的随机对照试验（RCT）,并应用RevMan 5.0软件进行统计分析,对纳入研究的方法学及质量进行评价.[结果]共纳入7组RCT.Meta分析结果表明,TACE与对症处理或全身静脉化疗相比,前者能降低无法手术切除肝癌患者1,2,3年死亡率,其RR（Risk Ratio）分别为1.254,95% CI 1.085～1.449,P=0.002;1.138,95% CI 1.023～1.266,P=0.017;1.128,95% CI 1.041～1.223,P=0.003,两者有显著差异.其中4组研究中肝癌患者的肝硬化以酒精性肝硬化占多数,TACE组1年死亡率与对照组1年死亡率差异无统计学意义（RR=1.095,95% CI 0.892～1.344,P=0.385）.[结论]与对症处理或全身静脉化疗相比,TACE治疗无法手术切除肝癌患者能提高其生存率,有一定的疗效.对合并酒精性肝硬化的肝癌患者TACE 的治疗效果尚需进一步临床试验证实.该结果对于指导临床治疗无法手术切除肝癌的方法选择具有一定的意义.

英文摘要：

[ Objective] To compare the effectiveness of transcatheter hepatic arterial chemoembolization （TACE） vs. symptomatic treatment or transvenous chemotherapy for unresectable hepatocellular carcinoma （HCC） in order to evaluate the efficacy of TACE. [Methods]MEDLINE（1980 - 2010）, EMBASE（1989- 2010）, clinical trial database on internet and chinese biomedicine database（1980-2010） were searched by computer. The randomized controlled trials of TACE vs. symptomatic treatment or transvenous chemotherapy for unresectable HCC were enrolled. RevMan 5.0 software was used for the statistical analysis. The methodology and quality of the study were evaluated. [Results] Seven randomized controlled trials were enrolled. Meta-analysis showed that TACE could decrease the 1-, 2- and 3-year mortality of unresectable HCC in comparison with symptomatic treatment or transvenous chemotherapy. The risk ratio was 1. 254, 95 % CI1. 085- 1. 449, P = 0. 002, 1. 138, 95%CI 1.023-1. 266, P =0. 017 and 1. 128, 95%CI1. 041-1. 223, P =0. 003, respectively. There were significant differences. The main type of hepatic cirrhosis in HCC patients in 4 groups was alcohol- ic cirrhosis. There was no significant difference in the 1-year mortality between TACE group and control group （RR= 1. 095, 95 % CI 0. 892 -1. 344, P = 0. 385）. [Conclusion]Compared with symptomatic treatment or transvenous chemotherapy, TACE for the treatment of patients with unresectable HCC can improve the overall survival rate and has a certain effect. The curative effect of TACE for HCC patients with alcoholic cirrhosis should be further confirmed. The research result has significance for the choice of clinical therapy methods of unresectable HCC.