a Oncology Center , Zhujiang Hospital of Southern Medical University , Guangzhou , Guangdong Province , China.
Expert Rev Gastroenterol Hepatol. 2019 Mar;13(3):271-279. doi: 10.1080/17474124.2019.1570135. Epub 2019 Jan 25.
Sorafenib (SOR) is recommended for locally advanced and metastatic hepatocellular carcinoma (HCC), but the tolerability of SOR is unsatisfactory. Selective internal radiotherapy (SIRT) has shown efficacy in intermediate-locally advanced HCC patients. This meta-analysis aimed to compare the efficacy and safety of SIRT and SOR in the treatment of intermediate-locally advanced HCC.
We systematically searched the PubMed, Embase, Cochrane Library and Web of Science databases for eligible studies. The endpoints evaluated included the overall survival (OS), disease control rate (DCR), objective response rate (ORR) and grade≥3 adverse events (AEs).
Six studies were included in this analysis. The OS was similar between the two groups (HR 1.06, 95%CI 0.93-1.20; P = 0.40). There was no difference in the DCR between the two groups (RR 1.13, 95%CI 0.87-1.46; P = 0.35). However, the ORR in the SIRT group was significantly higher than that in the SOR group (RR 4.10, 95%CI 1.92-8.76; P = 0.0003). The incidence rate of grade≥3 AEs was higher in the SOR group.
In patients with intermediate-locally advanced HCC, SIRT and SOR result in similar survival rates. The improved toxicity profile of SIRT may help when choosing between the two treatments.
索拉非尼（SOR）被推荐用于局部晚期和转移性肝细胞癌（HCC），但 SOR 的耐受性并不令人满意。选择性内放射治疗（SIRT）已显示出对中局部晚期 HCC 患者的疗效。本荟萃分析旨在比较 SIRT 和 SOR 治疗中局部晚期 HCC 的疗效和安全性。
我们系统地检索了 PubMed、Embase、Cochrane 图书馆和 Web of Science 数据库中的合格研究。评估的终点包括总生存期（OS）、疾病控制率（DCR）、客观缓解率（ORR）和≥3 级不良事件（AEs）。
共有 6 项研究纳入本分析。两组的 OS 相似（HR 1.06，95%CI 0.93-1.20；P = 0.40）。两组的 DCR 无差异（RR 1.13，95%CI 0.87-1.46；P = 0.35）。然而，SIRT 组的 ORR 明显高于 SOR 组（RR 4.10，95%CI 1.92-8.76；P = 0.0003）。SOR 组≥3 级 AEs 的发生率较高。
在中局部晚期 HCC 患者中，SIRT 和 SOR 的生存率相似。SIRT 改善的毒性特征可能有助于在两种治疗方法之间进行选择。
