Antonio Facciorusso1, Marianna Di Maso2, Nicola Muscatiello2. 1. Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy. Electronic address: antonio.facciorusso@virgilio.it. 2. Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy.
Abstract
BACKGROUND: Despite the promising results of earlier studies, a clear superiority of drug-eluting beads transarterial chemoembolization over conventional chemoembolization in unresectable hepatocellular carcinoma patients has not been established yet. AIMS: To evaluate the efficacy and safety of the two treatments in unresectable hepatocellular carcinoma patients. METHODS: Computerized bibliographic search on the main databases was performed. One-year, two-year, three-year survival rates were analyzed. Hazard ratios from Kaplan-Meier curves were extracted in order to perform an unbiased comparison of survival estimates. Objective response and severe adverse event rate were analyzed too. RESULTS: Four randomized-controlled trials and 8 observational studies with 1449 patients were included in the meta-analysis. Non-significant trends in favor of drug-eluting beads chemoembolization were observed as for 1-year (odds ratio: 0.76, 0.48-1.21, p=0.25), 2-year (odds ratio: 0.68, 0.42-1.12, p=0.13) and 3-year survival (odds ratio: 0.57, 0.32-1.01, p=0.06). Meta-analysis of plotted hazard ratios confirmed this trend (hazard ratio: 0.86, 0.71-1.03, p=0.10). Pooled data of objective response showed no significant difference between the two treatments (odds ratio: 1.21, 0.69-2.12, p=0.51). No statistically significant difference in adverse events was registered (odds ratio: 0.85, 0.60-1.20, p=0.36). CONCLUSIONS: Our results stand for a non-superiority of drug-eluting beads chemoembolization with respect to conventional chemoembolization in hepatocarcinoma patients.
BACKGROUND: Despite the promising results of earlier studies, a clear superiority of drug-eluting beads transarterial chemoembolization over conventional chemoembolization in unresectable hepatocellular carcinomapatients has not been established yet. AIMS: To evaluate the efficacy and safety of the two treatments in unresectable hepatocellular carcinomapatients. METHODS: Computerized bibliographic search on the main databases was performed. One-year, two-year, three-year survival rates were analyzed. Hazard ratios from Kaplan-Meier curves were extracted in order to perform an unbiased comparison of survival estimates. Objective response and severe adverse event rate were analyzed too. RESULTS: Four randomized-controlled trials and 8 observational studies with 1449 patients were included in the meta-analysis. Non-significant trends in favor of drug-eluting beads chemoembolization were observed as for 1-year (odds ratio: 0.76, 0.48-1.21, p=0.25), 2-year (odds ratio: 0.68, 0.42-1.12, p=0.13) and 3-year survival (odds ratio: 0.57, 0.32-1.01, p=0.06). Meta-analysis of plotted hazard ratios confirmed this trend (hazard ratio: 0.86, 0.71-1.03, p=0.10). Pooled data of objective response showed no significant difference between the two treatments (odds ratio: 1.21, 0.69-2.12, p=0.51). No statistically significant difference in adverse events was registered (odds ratio: 0.85, 0.60-1.20, p=0.36). CONCLUSIONS: Our results stand for a non-superiority of drug-eluting beads chemoembolization with respect to conventional chemoembolization in hepatocarcinoma patients.
Authors: L Cardarelli-Leite; A Hadjivassiliou; D Klass; J Chung; S G F Ho; H J Lim; P T W Kim; A Mujoomdar; D M Liu Journal: Curr Oncol Date: 2020-11-01 Impact factor: 3.677