Journal
DIGESTIVE AND LIVER DISEASE
Volume 48, Issue 6, Pages 571-577Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.dld.2016.02.005
Keywords
cTACE; DEB-TACE; HCC; Survival
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Background: Despite the promising results of earlier studies, a clear superiority of drug-eluting beads transarterial chemoembolization over conventional chemoembolization in unresectable hepatocellular carcinoma patients has not been established yet. Aims: To evaluate the efficacy and safety of the two treatments in unresectable hepatocellular carcinoma patients. Methods: Computerized bibliographic search on the main databases was performed. One-year, two-year, three-year survival rates were analyzed. Hazard ratios from Kaplan-Meier curves were extracted in order to perform an unbiased comparison of survival estimates. Objective response and severe adverse event rate were analyzed too. Results: Four randomized-controlled trials and 8 observational studies with 1449 patients were included in the meta-analysis. Non-significant trends in favor of drug-eluting beads chemoembolization were observed as for 1-year (odds ratio: 0.76, 0.48-1.21, p = 0.25), 2-year (odds ratio: 0.68, 0.42-1.12, p = 0.13) and 3-year survival (odds ratio: 0.57, 0.32-1.01, p = 0.06). Meta-analysis of plotted hazard ratios confirmed this trend (hazard ratio: 0.86, 0.71-1.03, p = 0.10). Pooled data of objective response showed no significant difference between the two treatments (odds ratio: 1.21, 0.69-2.12, p = 0.51). No statistically significant difference in adverse events was registered (odds ratio: 0.85, 0.60-1.20, p = 0.36). Conclusions: Our results stand for a non-superiority of drug-eluting beads chemoembolization with respect to conventional chemoembolization in hepatocarcinoma patients. (C) 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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