Doxorubicin-eluting beads versus conventional transarterialchemoembolization for the treatment of hepatocellular carcinoma: a meta-analysis.

OBJECTIVE

We conducted a meta-analysis to evaluate the efficacy and toxicity of DEB-TACE in the treatment of patients with intermediate-stage HCC.

METHODS

Studies published in PubMed, Embase and Web of Science, were systematically reviewed to identify those that assessed the efficacy and toxicity of DEB-TACE in the treatment of patients with HCC. Hazard ratio, risk ratioand 95% confidence intervalswere calculated, using a fixed-effects model or a random-effects model.

RESULTS

Nine studies with a total of 830 patients met the inclusion criteria were included in this study. DEB-TACE significantly improved overall survivaland progression free survival, and also increased objective response rateand disease control rate. However, in subgroup analyses, pooled results showed that, the survival benefits of DEB-TACE were not found in the randomized controlled trials, but were observed in Non-RCTs. The incidence of most common adverse events, including nausea, pain, fever, and fatigue, was not significant difference between the DEB-TACE group and conventional TACEgroup.

CONCLUSIONS

Despite DEB-TACE significantly prolonged the survival and response rate in the patients with HCC, the conclusion about the survival benefits should be interpreted with caution, since these findings were only found in retrospective Non-RCTs, and not in prospective RCTs.