Meta-analysis Of Randomized Controlled Trials On The Therapeutic Efficacy And Safety Of TACE Combined With Sorafenib In Treating Advanced Liver Cancer

Objective:This meta-analysis is to systemically evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE)combined with sorafenib versus that of TACE alone in the treatment for advanced liver cancer.Methods:The original articles were Searched from Cochrane Library,PubMed,Embase,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Database and China Biology Medicine disc(CBM)from inception to October 2017.Then we recruited the articles about randomized controlled trial of the efficacy and adverse effects of TACE combined with sorafenib compared with that of TACE alone.Finally,we performed a meta-analysis of the eligible articles by using Statal2.0.Results:thirteen randomized controlled trials reports,including 1739 patients with advanced liver cancer were recruited in this study.Meta-analysis showed that compared with TACE alone,TACE combined with sorafenib can significantly improve the 1-year survival rate,median survival time,progression-free survival time(RR1-year survival rate=1.521,95%CI:1.375～1.683,p=0.001;ESmOS=0.241,95%CI:0.186～0.296,p=0.001;ESpfs=0.352,95%CI:0.269～0.436,p=0.001)and objective response rate(RRORR=1.521,95%Cl:1.375～1.683,p=0.001)for the treatment of HCC.The main adverse reactions of TACE combined with sorafenib treatment include hand-foot reaction,vomiting,hypertension,bone marrow suppression.However,there was no significant difference in diarrhea,fever,and liver function abnormalities compared with TACE alone.Subgroup analysis showed that taking sorafenib as soon as possible(within 4 days after TACE)can benefit patients with prolonged progression-free survival.Conclusion:TACE combined with Sorafenib was associated with superior early treatment response and survival in comparison TACE monotherapy for patients with advanced HCC.