A comparison between drug-eluting bead-transarterial chemoembolization and conventional transarterial chemoembolization in patients with hepatocellular carcinoma: A meta-analysis of six randomized controlled trials
Hongye Wang1, Cheng Cao1, Xiyi Wei2, Kangjie Shen1, Yimei Shu1, Xiaojie Wan3, Jinyu Sun1, Xiaohan Ren2, Yuxiang Dong1, Yihai Liu4, Bo Zhai5
1 Department of Lightning Scientific Research Lab, The First Clinical Medical School, Nanjing Medical University, Nanjing, China
2 Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
3 Department of Lightning Scientific Research Lab, Clinical School of Imaging, Nanjing Medical University, Nanjing, China
4 Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing, China
5 Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai
Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing Medical University, Nanjing
Source of Support: None, Conflict of Interest: None
Objective: Transarterial chemoembolization (TACE) is the standard treatment for unresectable intermediate hepatocellular carcinoma. Drug-eluting beads (DEB)-TACE is a promising approach expected to improve the efficiency and safety of conventional (c) TACE. However, controversy remains whether DEB-TACE performs better than cTACE. This meta-analysis aimed to compare cTACE and DEB-TACE in terms of overall survival (OS), adverse events, and response rate. Literature search was performed in PubMed, Cochrane, Embase, and Web of Science. Complete response (CR), partial response (PR), disease control (DC), stable disease (SD), OS, and major complications were compared between these two modalities. The pooled relative risk and 95% confidence interval were calculated for assessment. Six randomized controlled trials were included for further analysis after a comprehensive search. No significant difference was found in overall response at 3, 6, 9, and 12 months, CR, PR, DC (SD), OS and complications between cTACE and DEB-TACE.
Conclusion: DEB-TACE had similar therapeutic effects to those of cTACE. Furthermore, major complications in both therapies were similar. The superiority of DEB-TACE over cTACE remains unclear, and further research with high-quality evidence is needed.