Efficacy and safety of cTACE versus DEB-TACE in patients with hepatocellular carcinoma: a meta-analysis

OBJECTIVE: Conflicting results of the efficacy and safety of conventional transarterial chemo-embolization (cTACE) vs drug-eluting bead (DEB)-TACE have been reported. This meta-analysis aimed to update and re-evaluate the efficacy and safety of cTACE compared with those of DEB-TACE in patients with hepatocellular carcinoma (HCC). METHODS: Literature search was performed by two investigators independently in PubMed, MEDLINE and EMBASE to screen studies published from January 1990 to March 2015. Studies of parallel group designs comparing cTACE and DEB-TACE for HCC were reviewed. Complete response, partial response, objective response, disease control, overall survival and survival time were collected to evaluate the efficacy of each therapy. RESULTS: DEB-TACE increased the complete response rate [odds ratio (OR) 1.38, 95% confidence interval (CI) 1.01-1.89], overall survival rate (OR 1.41, 95% CI 1.01-1.98) and survival time [weighted mean difference (WMD) 6.65, 95% CI 6.15-7.14) with less common adverse events (OR 0.59, 95% CI 0.41-0.84). However, DEB-TACE had a similar partial response rate (OR 1.00, 95% CI 0.67-1.49), objective response rate (OR 1.21, 95% CI 0.94-1.56), disease control rate (OR 1.14, 95% CI 0.81-1.58) and serious adverse events (OR 0.86, 95% CI 0.50-1.49) compared with cTACE. CONCLUSIONS: DEB-TACE has a higher complete response rate and a higher overall survival rate in patients with HCC than cTACE; however, the results should be interpreted with caution. Furthermore, DEB-TACE is safer and has less common adverse events than cTACE.