Unresectable Hepatocellular Carcinoma: Radioembolization Versus Chemoembolization: A Systematic Review and Meta-analysis

Background Transarterial radioembolization (TARE) has emerged as a newer regional therapy to transarterial chemoembolization (TACE) for treatment of unresectable hepatocellular carcinoma (HCC). The aim of this study is to compare clinical outcomes of both the techniques. Methods Online search for st...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2016-11, Vol.39 (11), p.1580-1588
Main Authors: Lobo, Laila, Yakoub, Danny, Picado, Omar, Ripat, Caroline, Pendola, Fiorella, Sharma, Rishika, ElTawil, Rana, Kwon, Deukwoo, Venkat, Shree, Portelance, Loraine, Yechieli, Raphael
Format: Article
Language:English
Subjects:
Carcinoma, Hepatocellular - mortality
Carcinoma, Hepatocellular - therapy
Cardiology
Chemoembolization, Therapeutic - methods
Cost-Benefit Analysis
Embolization, Therapeutic - methods
EPIDEMIOLOGY
FATIGUE
FEVER
Full
HAZARDS
HEPATOMAS
HOSPITALS
Humans
Imaging
Liver Neoplasms - mortality
Liver Neoplasms - pathology
Liver Neoplasms - therapy
Medicine
Medicine & Public Health
NAUSEA
Nuclear Medicine
PAIN
PATIENTS
Prospective Studies
RADIOEMBOLIZATION
Radiology
RADIOLOGY AND NUCLEAR MEDICINE
REVIEWS
Scientific Paper
Survival Rate
Treatment Outcome
Ultrasound
VOMITING
Yttrium Radioisotopes - therapeutic use
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Summary:Background Transarterial radioembolization (TARE) has emerged as a newer regional therapy to transarterial chemoembolization (TACE) for treatment of unresectable hepatocellular carcinoma (HCC). The aim of this study is to compare clinical outcomes of both the techniques. Methods Online search for studies comparing TARE to TACE from 2005 to present was performed. Primary outcome was overall survival rate for up to 4 years. Secondary outcomes included post-treatment complications and treatment response. Quality of included studies was evaluated by STrengthening the Reporting of OBservational studies in Epidemiology criteria. Relative risk (RR) and 95 % confidence intervals (CI) were calculated from pooled data. Results The search strategy yielded 172 studies, five met selection criteria and included 553 patients with unresectable HCC, 284 underwent TACE and 269 underwent TARE. Median ages were 63 and 64 years for TACE and TARE, respectively. Meta-analysis showed no statistically significant difference in survival for up to 4 years between the two groups (HR = 1.06; 95 % CI 0.81–1.46, p  = 0.567). TACE required at least one day of hospital stay compared to TARE which was mostly an outpatient procedure. TACE had more post-treatment pain than TARE (RR = 0.51, 95 % CI 0.36–0.72, p  
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-016-1426-y