The Efficacy Of Transcatheter Arterial Chemoembolization Combined With Radiation Therapy Versus Transcatheter Arterial Chemoembolization For Hepatocellular Carcinoma With Portal Vein Tumor Thrombus:a Meta-analysis

ObjectiveThe aim of this meta-analysis is to investigate the efficacy of transcatheter arterial chemoembolization combined with radiotherapy verse transcatheter arterial chemoembolization in the treatment of portal vein tumor thrombus with hepatocellular carcinoma by comparing the recent total response rate of tumor thrombus and the recent total response rate of tumor and long-term survival.MethodA comprehensive search by computer was conducted in PubMed,Embase,Cochrane Library,Web of Science,Google Scholar,ClinicalTrials.org,SinoMed,VIP,CNKI and Wanfang.Blind screening of relevant literature on TACE and RT combined or without combined treatment of hepatocellular carcinoma with portal vein tumor thrombus since January 1997 to January 2018.Quality evaluation and data extraction of the included literature.The data extraction mainly included TACE combined with RT and TACE alone for the treatment of hepatocellular carcinoma with portal vein tumor thrombus.The total effective rates were tumor thrombus and tumor response,1-year survival rate,and 2-year survival rate.Finally,RevMan 5.3 software was used to analyze the extracted data.ResultThrough searching domestic and foreign databases,the inclusion and exclusion criteria were established.A total of 18 articles were included.The total number of patients was 2237.The number of cases using TACE combined with RT as the initial treatment program was 761 while TACE alone was 1476.Meta-analysis results showed that TACE combined with RT group compared with TACE alone in treatment of inoperable hepatocellular carcinoma with portal vein tumor thrombus can significantly improve the total effective rate of recent tumor thrombus reaction(OR = 3.59,95% CI: 2.82 ~ 4.57,P <0.05)and the total effective rate of recent tumor response(OR = 2.76,95% CI: 2.19 ~ 3.49,P <0.05)and 1-year overall survival rate(OR=2.93,95%CI: 2.36 to 3.64,P<0.05)and 2-year overall survival rate(OR=3.14,95% CI: 2.28 to 4.32,P<0.05).ConclusionFor the treatment of inoperable hepatocellular carcinoma with portal vein tumor thrombus,TACE combined with RT is superior to TACE alone,in the recent total response rate of tumor thrombus and the recent total response rate of tumor and 1-year overall survival and 2-year overall survival.