Transarterial radioembolization versus chemoembolization for hepatocellular carcinoma: a meta-analysis.

IF 3.5 3区 医学 Q2 ONCOLOGY Frontiers in Oncology Pub Date : 2025-01-17 eCollection Date: 2024-01-01 DOI:10.3389/fonc.2024.1511210
Wenxiao Lu, Tongsheng Zhang, Fengfei Xia, Xiangzhong Huang, Fulei Gao
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Abstract

Background: Currently, inoperable hepatocellular carcinoma (HCC) is treated by both transarterial radioembolization (TARE) and transarterial chemoembolization (TACE). However, their relative efficacy and outcomes remain unclear. This meta-analysis aimed to compare TARE and TACE to evaluate their safety and efficacy in treating inoperable HCC patients.

Methods: Relevant studies were identified by searching the Web of Science, PubMed, and Wanfang databases. Pooled analyses were used to compare treatment response rates, complications, and overall survival (OS) outcomes between the TARE and TACE groups.

Results: This analysis selected 8 studies comprising 1026 and 358 patients that respectively underwent TACE and TARE treatment. The results revealed that the TARE group had significantly higher pooled total response, disease control, and 1-year OS rates compared to the TACE group (P = 0.04, 0.003, and 0.02, respectively), with a corresponding increase in OS (P = 0.0002). Furthermore, rates of complications including fever and abdominal pain were also reduced in the TARE group (P = 0.006 and 0.02, respectively). Moreover, there were no significant differences in the pooled analyses of complete response rates, fatigue, nausea/vomiting, 3-year OS, or 5-year OS between these groups (P = 0.24, 0.69, 0.15, 0.73, and 0.38, respectively). Significant heterogeneity was detected for endpoints including fatigue, nausea/vomiting, fever, abdominal pain, OS duration, and 3-year OS (I2 = 89%, 82%, 72%, 90%, 96%, and 66%, respectively). All endpoints exhibited no significant risk of publication bias.

Conclusions: This study revealed that relative to TACE, TARE performed using 90Y can yield significantly higher treatment response rates and prolong HCC patient survival with fewer treatment-related side effects.The PRISMA guidelines were used to guide the execution and publication of this meta-analysis. The study is registered at INPLASY.COM (No. INPLASY202380017).

Systematic review registration: INPLASY.COM, identifier INPLASY202380017.

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经动脉放射栓塞与化疗栓塞治疗肝细胞癌:荟萃分析。
背景:目前,不能手术的肝细胞癌(HCC)的治疗方法有经动脉放射栓塞(TARE)和经动脉化疗栓塞(TACE)两种。然而,它们的相对疗效和结果仍不清楚。本荟萃分析旨在比较TARE和TACE治疗不能手术的HCC患者的安全性和有效性。方法:通过检索Web of Science、PubMed和万方数据库,对相关研究进行筛选。采用合并分析比较TARE组和TACE组的治疗反应率、并发症和总生存期(OS)结果。结果:本分析选择了8项研究,分别包括1026例和358例接受TACE和TARE治疗的患者。结果显示,与TACE组相比,TARE组的总有效率、疾病控制率和1年OS率均显著高于TACE组(P = 0.04、0.003和0.02),OS相应增加(P = 0.0002)。此外,TARE组的并发症发生率(包括发烧和腹痛)也有所降低(P分别= 0.006和0.02)。此外,在完全缓解率、疲劳、恶心/呕吐、3年OS或5年OS的汇总分析中,两组之间没有显著差异(P分别= 0.24、0.69、0.15、0.73和0.38)。在疲劳、恶心/呕吐、发热、腹痛、OS持续时间和3年OS等终点上发现了显著的异质性(I2分别为89%、82%、72%、90%、96%和66%)。所有终点均未显示显著的发表偏倚风险。结论:本研究显示,与TACE相比,使用90Y进行TARE治疗可显著提高治疗缓解率,延长HCC患者生存期,治疗相关副作用更少。PRISMA指南用于指导本荟萃分析的执行和发表。本次研究已在INPLASY.COM注册。INPLASY202380017)。系统评价注册:INPLASY.COM,标识符INPLASY202380017。
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来源期刊
Frontiers in Oncology
Frontiers in Oncology Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
6.20
自引率
10.60%
发文量
6641
审稿时长
14 weeks
期刊介绍: Cancer Imaging and Diagnosis is dedicated to the publication of results from clinical and research studies applied to cancer diagnosis and treatment. The section aims to publish studies from the entire field of cancer imaging: results from routine use of clinical imaging in both radiology and nuclear medicine, results from clinical trials, experimental molecular imaging in humans and small animals, research on new contrast agents in CT, MRI, ultrasound, publication of new technical applications and processing algorithms to improve the standardization of quantitative imaging and image guided interventions for the diagnosis and treatment of cancer.
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