Doxorubicin‐eluting beads versus conventional transarterial chemoembolization for the treatment of hepatocellular carcinoma
- 13 November 2013
- journal article
- research article
- Published by Wiley in Journal of Gastroenterology and Hepatology
- Vol. 29 (5), 920-925
- https://doi.org/10.1111/jgh.12439
Abstract
Background and Aim Doxorubicin‐eluting bead transarterial chemoembolization (DEB‐TACE) is a novel locoregional treatment for unresectable hepatocellular carcinoma (HCC). However, to date, the benefits of DEB‐TACE versus conventional transarterial chemoembolization (TACE) remain unclear. This meta‐analysis was conducted to evaluate the efficacy and safety of the two treatments for patients with unresectable HCC. Methods We searched for relevant articles by means of computerized bibliographic search and complementary manual search. Objective tumor response, overall survival, and adverse events were then calculated and analyzed. Results A total of seven clinical studies with 700 participants were included in the current meta‐analysis. Significantly better objective tumor response was found for DEB‐TACE than for conventional TACE (OR = 1.92, 95% CI [1.34, 2.77]; P = 0.0004), with relative risk difference of 0.15 [0.07, 0.24] (P = 0.0003). One‐year and 2‐year survival rates were statistically significantly higher for DEB‐TACE compared with conventional TACE (Peto OR, 95% CI: 0.64 [0.46, 0.89], P = 0.007; 0.61 [0.47, 0.80], P = 0.0003, respectively). Peto ORs of 6‐month and 3‐year survival were 0.72 [0.46, 1.14] (P = 0.16) and 0.77 [0.55, 1.06] (P = 0.11), respectively, showing no difference statistically. However, we could still find a tendency favoring DEB‐TACE. Adverse side effects were similar in both groups, with postembolization syndrome occurring most commonly. Conclusions This meta‐analysis shows that DEB‐TACE provides significantly better tumor response compared with conventional TACE. One‐year and 2‐year survival are better with DEB‐TACE. In addition, DEB‐TACE is as safe as conventional TACE. Therefore, DEB‐TACE is a better choice for HCC patients for whom curative treatments like liver transplantation and liver resection are not suitable.Funding Information
- National undergraduate innovation training programs (201210558072)
- National Natural Science Foundation of China (81370574)
- Guangdong Natural Science Foundation (S2012010009376)
- Science and Technology Planning Project of Guangdong Province, China (2011B031800057)
This publication has 32 references indexed in Scilit:
- Comparative study between doxorubicin-eluting beads and conventional transarterial chemoembolization for treatment of hepatocellular carcinomaJournal of Hepatology, 2012
- Liver, Gastrointestinal, and Cardiac Toxicity in Intermediate Hepatocellular Carcinoma Treated With PRECISION TACE With Drug-Eluting Beads: Results From the PRECISION V Randomized TrialAmerican Journal of Roentgenology, 2011
- Drug-eluting bead loaded with doxorubicin versus conventional Lipiodol-based transarterial chemoembolization in the treatment of hepatocellular carcinomaEuropean Journal of Gastroenterology & Hepatology, 2011
- Transarterial Chemoembolization of Child-A hepatocellular carcinoma: Drug-eluting bead TACE (DEB TACE) vs. TACE with Cisplatin/Lipiodol (cTACE)Medical Science Monitor, 2011
- Comparison of conventional transarterial chemoembolization (TACE) and chemoembolization with doxorubicin drug eluting beads (DEB) for unresectable hepatocelluar carcinoma (HCC)Journal of Surgical Oncology, 2010
- Prospective Randomized Study of Doxorubicin-Eluting-Bead Embolization in the Treatment of Hepatocellular Carcinoma: Results of the PRECISION V StudyCardioVascular and Interventional Radiology, 2009
- Hepatocellular Carcinoma Incidence, Mortality, and Survival Trends in the United States From 1975 to 2005Journal of Clinical Oncology, 2009
- Practical methods for incorporating summary time-to-event data into meta-analysisTrials, 2007
- Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survivalHepatology, 2003
- Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trialThe Lancet, 2002