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Review
. 2014 Dec 7;20(45):17227-34.
doi: 10.3748/wjg.v20.i45.17227.

3D conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma

Li-Qun Zou  1 , Bing-Lan Zhang  1 , Qing Chang  1 , Fu-Ping Zhu  1 , Yan-Yan Li  1 , Yu-Quan Wei  1 , Yong-Song Guan  1
Affiliations
Review

3D conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma

Li-Qun Zou et al. World J Gastroenterol. .

Abstract

Aim: To compare transcatheter arterial chemoembolization (TACE) and 3D conformal radiotherapy (3D-CRT) with TACE monotherapy in hepatocellular carcinoma (HCC).

Methods: We searched all the eligible studies from the Cochrane Library, PubMed, Medline, Embase, and CNKI. The meta-analysis was performed to assess the survival benefit, tumor response, and the decline in α-fetoprotein (AFP) level. According to the heterogeneity of the studies, pooled OR with 95%CI were calculated using the fixed-effects or random-effects model. An observed OR > 1 indicated that the addition of 3D-CRT to TACE offered survival benefits to patients that could be considered statistically significant. Statistical analyses were performed using Review Manager Software.

Results: Ten studies met the criteria to perform a meta-analysis including 908 HCC participants, with 400 patients in the TACE/3D-CRT combination group and 508 in the TACE alone group. TACE combined with 3D-CRT significantly improved 1-, 2- and 3-year overall survival compared with TACE monotherapy (OR = 1.87, 95%CI: 1.37-2.55, P < 0.0001), (OR = 2.38, 95%CI: 1.78-3.17, P < 0.00001) and (OR = 2.97, 95%CI: 2.10-4.21, P < 0.00001). In addition, TACE plus 3D-CRT was associated with a higher tumor response (complete remission and partial remission) (OR = 3.81; 95%CI: 2.70-5.37; P < 0.00001), and decline rates of AFP level (OR = 3.24, 95%CI: 2.09-5.02, P < 0.00001).

Conclusion: This meta-analysis demonstrated that TACE combined with 3D-CRT was better than TACE monotherapy for patients with HCC, which needs to be confirmed by large multicenter trials．

Keywords: Chemoembolization; Hepatocellular carcinoma; Meta-analysis; Three-dimensional conformal radiotherapy.

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Figures

Figure 1
Figure 1
Route and results of including trials in the meta-analysis.
Figure 2
Figure 2
Outcomes of overall survival of combination therapy compared with sole transcatheter arterial chemoembolization therapy alone.
Figure 3
Figure 3
Better tumor response and higher decline in α fetal protein level were shown in patients treated with combination therapy.
Figure 4
Figure 4
No significant asymmetry was revealed in 1-year (A), 2-year (B) and 3-year (C) overall survival.
Figure 5
Figure 5
No publication bias was found in tumor response (A) and reduction in α fetal protein level (B).
See this image and copyright information in PMC

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References

    1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90. - PubMed
    1. Rahbari NN, Mehrabi A, Mollberg NM, Müller SA, Koch M, Büchler MW, Weitz J. Hepatocellular carcinoma: current management and perspectives for the future. Ann Surg. 2011;253:453–469. - PubMed
    1. Oliveri RS, Wetterslev J, Gluud C. Transarterial (chemo)embolisation for unresectable hepatocellular carcinoma. Cochrane Database Syst Rev. 2011;(3):CD004787. - PubMed
    1. Myers RP. Meta-analysis of transarterial embolization in patients with unresectable hepatocellular carcinoma. Radiology. 2003;227:611–612; author reply 612-613. - PubMed
    1. Cammà C, Schepis F, Orlando A, Albanese M, Shahied L, Trevisani F, Andreone P, Craxì A, Cottone M. Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials. Radiology. 2002;224:47–54. - PubMed

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