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Review
. 2021 Dec 7;13(24):6172.
doi: 10.3390/cancers13246172.

Conventional Transarterial Chemoembolization Versus Drug-Eluting Beads in Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Khalid I Bzeizi  1 , Mohammad Arabi  2 , Negar Jamshidi  3 , Ali Albenmousa  1 , Faisal M Sanai  4 , Waleed Al-Hamoudi  1 , Saad Alghamdi  1 , Dieter Broering  1 , Saleh A Alqahtani  1   5
Affiliations
Review

Conventional Transarterial Chemoembolization Versus Drug-Eluting Beads in Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Khalid I Bzeizi et al. Cancers (Basel). .

Abstract

Hepatocellular carcinoma (HCC) occurs in nearly three-quarters of all primary liver cancers, with the majority not amenable to curative therapies. We therefore aimed to re-evaluate the safety, efficacy, and survival benefits of treating patients with drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE) compared to the conventional transcatheter arterial chemoembolization (C-TACE). Several databases were searched with a strict eligibility criterion for studies reporting on adult patients with unresectable or recurrent HCC. The pooled analysis included 34 studies involving 4841 HCC patients with a median follow-up of 1.5 to 18 months. There were no significant differences between DEB-TACE and C-TACE with regard to complete response, partial response and disease stability. However, disease control (OR: 1.42 (95% CI (1.03,1.96) and objective response (OR: 1.33 (95% CI (0.99, 1.79) were significantly more effective for DEB-TACE treatment with fewer severe complications and all-cause mortality. The pooled-analysis did not find superiority of DEB-TACE in complete or partial response, disease stability, controlling disease progression, and 30 day or end-mortality. However, results showed that DEB-TACE is associated with a better objective response, disease control, and lower all-cause mortality with severe complications compared to C-TACE treatment. Given that the safety outcomes are based on limited studies with a potential for bias, there was no clear improvement of DEB-TACE over C-TACE treatment.

Keywords: drug-eluting beads; hepatocellular carcinoma; transarterial chemoembolization.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the process for study selection.
Figure 2
Figure 2
Forest plots for (A) complete response analysis; (B) partial response analysis; (C) objective response analysis between DEB-TACE (experimental) and c-TACE (control) treatment in patients with hepatocellular carcinoma.
Figure 2
Figure 2
Forest plots for (A) complete response analysis; (B) partial response analysis; (C) objective response analysis between DEB-TACE (experimental) and c-TACE (control) treatment in patients with hepatocellular carcinoma.
Figure 3
Figure 3
Forest plots for (A) disease stability; (B) disease control; (C) disease progression analysis between DEB-TACE (experimental) and C-TACE (control) treatment in patients with hepatocellular carcinoma.
Figure 3
Figure 3
Forest plots for (A) disease stability; (B) disease control; (C) disease progression analysis between DEB-TACE (experimental) and C-TACE (control) treatment in patients with hepatocellular carcinoma.
Figure 4
Figure 4
Forest plots for safety outcomes between DEB-TACE (experimental) and C-TACE (control) treatment in patients with hepatocellular carcinoma (A) systemic effects; (B) serious adverse events; (C) 30-day mortality; (D) end mortality.
Figure 4
Figure 4
Forest plots for safety outcomes between DEB-TACE (experimental) and C-TACE (control) treatment in patients with hepatocellular carcinoma (A) systemic effects; (B) serious adverse events; (C) 30-day mortality; (D) end mortality.
See this image and copyright information in PMC

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