Yang Yi, Si Tongguo
School of Medical Imaging, Tianjin Medical University, Tianjin 300203, China.
Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
Cancer Biol Med. 2018 Aug;15(3):299-310. doi: 10.20892/j.issn.2095-3941.2017.0177.
To compare the effects and safety of conventional transarterial chemoembolization (cTACE) and yttrium-90 transarterial radioembolization [TARE (90Y)] for hepatocellular carcinoma (HCC).
Nine high-quality observational studies, one low bias-risk randomized controlled trial (RCT), and one moderate bias-risk RCT included 1,652 patients [cTACE, 1,124; TARE (90Y), 528], from whom data were extracted for this systematic review and meta-analysis.
The extracted study outcomes included 1-year and 2-year overall survival (OS) rates, objective responses (ORs), and serious adverse events (AEs). 1-year OS rates: OR = 0.939, 95 % CI: 0.705-1.251, = 0.66. 2-year OS rates: overall pooled OR = 0.641, 95% CI: 0.382-1.075, = 0.092; observational study subgroup OR = 0.575, 95% CI: 0.336-0.984, = 0.043; RCT subgroup OR* = 0.641, 95% CI: 0.382-1.075, = 0.346. OR: overall pooled OR = 0.781, 95% CI: 0.454-1.343, = 0.371; mRECIST subgroup OR = 0.584, 95 % CI: 0.349-0.976, = 0.040; WHO subgroup OR = 1.065; 95% CI: 0.500-2.268, = 0.870. Serious AEs: overall pooled RR = 1.477, 95% CI: 0.864-2.526, = 0.154; RCT subgroup RR = 0.680, 95% CI: 0.325-1.423, = 0.306; observational study subgroup RR = 1.925; 95 % CI: 0.978-3.788, = 0.058.
TARE (90Y) increased 2-year OS rates in the observational subgroup and resulted in better OR rates, according to mRECIST criteria, in comparison with cTACE. Furthermore, a lower risk of AEs was observed for TARE (90Y) than for cTACE.
比较传统经动脉化疗栓塞术（cTACE）与钇-90经动脉放射性栓塞术[TARE（90Y）]治疗肝细胞癌（HCC）的疗效和安全性。
9项高质量观察性研究、1项低偏倚风险随机对照试验（RCT）和1项中度偏倚风险RCT纳入了1652例患者[cTACE组1124例；TARE（90Y）组528例]，从中提取数据进行本系统评价和荟萃分析。
提取的研究结局包括1年和2年总生存率（OS）、客观缓解率（OR）和严重不良事件（AE）。1年OS率：OR = 0.939，95%CI：0.705 - 1.251，P = 0.66。2年OS率：总体合并OR = 0.641，95%CI：0.382 - 1.075，P = 0.092；观察性研究亚组OR = 0.575，95%CI：0.336 - 0.984，P = 0.043；RCT亚组OR* = 0.641，95%CI：0.382 - 1.075，P = 0.346。OR：总体合并OR = 0.781，95%CI：0.454 - 1.343，P = 0.371；mRECIST亚组OR = 0.584，95%CI：0.349 - 0.976，P = 0.040；WHO亚组OR = 1.065，95%CI：0.500 - 2.268，P = 0.870。严重AE：总体合并RR = 1.477，95%CI：0.864 - 2.526，P = 0.154；RCT亚组RR = 0.680，95%CI：0.325 - 1.423，P = 0.306；观察性研究亚组RR = 1.925，95%CI：0.978 - 3.788，P = 0.058。
与cTACE相比，TARE（90Y）提高了观察性亚组的2年OS率，并且根据mRECIST标准，OR率更高。此外，观察到TARE（90Y）的AE风险低于cTACE。
