Zou Jing Huai, Zhang Lan, Ren Zheng Gang, Ye Sheng Long
Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
J Dig Dis. 2016 Aug;17(8):510-517. doi: 10.1111/1751-2980.12380.
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).
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.
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.
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.
关于传统经动脉化疗栓塞术（cTACE）与载药微球（DEB）-TACE的疗效和安全性，已有相互矛盾的研究结果报道。本荟萃分析旨在更新并重新评估cTACE与DEB-TACE治疗肝细胞癌（HCC）患者的疗效和安全性。
由两名研究者独立在PubMed、MEDLINE和EMBASE中进行文献检索，以筛选1990年1月至2015年3月发表的研究。对比较cTACE和DEB-TACE治疗HCC的平行组设计研究进行综述。收集完全缓解、部分缓解、客观缓解、疾病控制、总生存期和生存时间，以评估每种治疗方法的疗效。
DEB-TACE提高了完全缓解率[比值比（OR）1.38，95%置信区间（CI）1.01-1.89]、总生存率（OR 1.41，95% CI 1.01-1.98）和生存时间[加权平均差（WMD）6.65，95% CI 6.15-7.14]，且不良事件较少见（OR 0.59，95% CI 0.41-0.84）。然而，与cTACE相比，DEB-TACE的部分缓解率（OR 1.00，95% CI 0.67-1.49）、客观缓解率（OR 1.21，95% CI 0.94-1.56）、疾病控制率（OR 1.14，95% CI 0.81-1.58）和严重不良事件（OR 0.86，95% CI 0.50-1.49）相似。
在HCC患者中，DEB-TACE的完全缓解率和总生存率高于cTACE；然而，对结果的解释应谨慎。此外，DEB-TACE比cTACE更安全，不良事件少见。
