Victory Srinivasan Nishok, Venugopal Sathish
General Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2023 Jun 18;15(6):e40592. doi: 10.7759/cureus.40592. eCollection 2023 Jun.
The purpose of this article is to review the existing English scientific literature and determine the superior modality between transarterial chemoembolization (TACE) and radioembolization (TARE) in the treatment of neuroendocrine liver metastases (NELMs). To that end, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search PubMed, the Cochrane Library, and Google Scholar. We identified 14 observational studies and no randomized controlled trials (RCTs) investigating the use of TACE or TARE to treat NELM. We used the Newcastle-Ottawa Scale to assess the risk of bias in these studies. We concluded that TACE and TARE appeared to have similar outcomes when comparing overall survival, progression-free survival, radiological response, symptomatic response, and the incidence of severe adverse events. Further large-scale RCTs are needed to identify the superior modality conclusively. We also identified several unique prognostic factors for overall survival, such as the neutrophil-lymphocyte ratio, volumetric multiparametric magnetic resonance imaging, serum albumin, alkaline phosphatase, and pancreastatin.
本文旨在回顾现有的英文科学文献，确定经动脉化疗栓塞术（TACE）和放射性栓塞术（TARE）在治疗神经内分泌肝转移瘤（NELMs）方面哪种方式更为优越。为此，我们遵循系统评价和Meta分析的首选报告项目（PRISMA）指南，检索了PubMed、Cochrane图书馆和谷歌学术。我们确定了14项观察性研究，没有随机对照试验（RCT）研究使用TACE或TARE治疗NELM。我们使用纽卡斯尔-渥太华量表评估这些研究中的偏倚风险。我们得出结论，在比较总生存期、无进展生存期、放射学反应、症状反应和严重不良事件发生率时，TACE和TARE似乎有相似的结果。需要进一步的大规模RCT来最终确定哪种方式更为优越。我们还确定了几个影响总生存期的独特预后因素，如中性粒细胞与淋巴细胞比值、容积多参数磁共振成像、血清白蛋白、碱性磷酸酶和胰抑制素。
