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放射性栓塞的系统回顾/荟萃分析

时间:2021-09-16 10:23来源:www.zljrlt.com 作者:杨宁肿瘤介入医学网
系统审查的棱流程图详细说明了数据库搜索、筛选的引用次数和检索到的全文。 初始结果 The OS was reported in all eight trials. 在所有8项试验中都报道了整体生存率(OS)。 The corresponding HR was reported in three trials, obtained through correspo



系统审查的棱流程图详细说明了数据库搜索、筛选的引用次数和检索到的全文。

初始结果


The OS was reported in all eight trials.
在所有8项试验中都报道了整体生存率(OS)。
 
The corresponding HR was reported in three trials, obtained through correspondence with the author in one trial [24], and extrapolated from reconstructed approximate individual patient data from published Kaplan-Meier curves in two trials [27,29].
在三个试验中报道了相应的风险比(HR),通过与作者在其中一个试验中的通信获得,并从两个试验中发表的Kaplan-Meier曲线重建的近似个体患者数据推断。
 
 We could not use the data from two trials in our analyses as they either solely provided the median survival or the survival rates at six and 12 months , respectively.
来自两个试验的数据不能用,因为它们要么分别提供了中位生存或6个月和12个月时的生存率。
 
 Y90-TARE was not associated with differences in overall survival (HR 0.99 [ 95% CI 0.81–1.21], six trials, I² = 77.6%, Fig 3) compared to standard of care.

与标准治疗相比,Y90-TARE总生存率的差异无关 ( HR0.99 [ 95% CI 0.81–1..21],6次试验,I²=77.6%  
 
Our results were comparable in our subgroup analyses (Table 2).
 
我们的结果在我们的亚组分析中具有可比性(表2)。

从时间到事件森林图分析 Forest plot of time-to-event outcomes

Cumulative (log)HR estimates with their 95% confidence intervals in the random-effects model for (A) overall survival, (B) progression-free survival, and (C) time to progression.
在随机效应模型中,总生存率、(A)无进展生存率和(C)进展时间的累积(log)HR估计的95%置信区间。

 
关于HR:HR 值的解释与 RR 几乎一致,即表示暴露组患病的概率为非暴露组的多少倍。但是与 logistic 回归不同的是,Cox 模型除了可以校正混杂因素外,还考虑了结局事件发生的时间。

啥叫“考虑了时间因素的 RR?我们可以理解为:与不吸烟人群相比,吸烟人群在 30 年内患肺癌的风险是不吸烟人群的10倍。注意“30 年内患肺癌的风险”,这是一个很含糊的说法:有人可能在随访开始第二年就发生肺癌,有人可能到随访快结束时(第三十年)才发生肺癌。如果构建四格表,这两个肺癌是同等看待的,但实际上,这两种肺癌的“社会危害性”显然是不能相提并论的!毕竟后者很有可能会多活二十多年。因此,我们在考虑结局事件是否发生的同时,往往还要考虑结局事件发生的时间!这就是 HR 存在的价值!


Y90-TARE = Yttrium-90 transarterial radioembolization. HR = hazard ratio. CI = confidence interval. N/A = not applicable.
 
aThe SIRTACE (Kolligs 2015) and YES-P (Mazzaferro 2019) trials had partially reported data and are therefore not included in the effect estimate and subgroup analyses for OS.


Secondary outcomes

Time to radiological progressionThe time to radiological progression was reported as two different outcomes in the included trials: progression-free survival and/or time to progression.
到放射学进展的时间在纳入的试验中,放射学进展的时间被报告为两种不同的结果:无进展生存期和/或到进展的时间。
 
 Progression-free survival was reported in four trials 
在4项试验中报道了无进展生存期,
 
The corresponding HR was reported in two trials] and extrapolated from published Kaplan-Meier curves in one trial [27].
两个试验中报道了相应的HR,并从一项试验中发表的Kaplan-Meier曲线推算。
 
 We could not use the data in our quantitative analyses in another trial [25] providing solely a median progression-free survival with its 95% CI.
我们不能在另一项试验的定量分析中使用这些数据,仅提供其95%可信区间的中位数无进展生存率。
 
 The time to progression was reported in five trials 
5项试验报道了进展的时间。
 
 The corresponding HR were reported in two trials [23,29], obtained through author correspondence in one trial [24] and extrapolated using a previously described algorithm in one trial [27], but with only partial data.
相应的HR在两个试验[23,29]中被报道,通过一个试验[24]中的作者通信获得,并在一个试验[27]中使用前面描述的算法进行外推,但只有部分数据。
 Y90-TARE yielded no differences in progression-free survival (Fig 3, Table A in S3 Appendix) and time to progression (Fig 3).
Y90-TARE在无进展生存期(图3,S3附录中的表A)和进展时间(图3)方面没有任何差异。
 Y90-TARE yielded a significantly longer time to progression in the glass microsphere subgroup (HR 0.
Y90-TARE在玻璃微球亚组中产生的进展时间明显更长(HR0。
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