Meta-analysis Of Clinical Efficacy Of Tace Combined With ¹²⁵I Radioactive Particles In Patients With Hepatocellular Carcinoma Complicated With Portal Vein Tumor Thrombus

Objective:Systematic evaluation of the safety and efficacy of transcatheter arterial chemoembolization?TACE?combined with ¹²⁵I particle implantation in the treatment of hepatocellular carcinoma?HCC?with portal vein tumor thrombus?PVTT?.Methods:A comprehensive search by computer was conducted in PubMed,Embase,Web of Science,Cochrane Library,China National Knowledge Infrastructure,China BiologyMedicine and Wanfang.Eligible trials that TACE combined iodine-125 implantation for the treatment HCC with PVTT were searched by two investigators and the references in eligible trials were retrieved.The retrieval period is from database construction to December 31,2019.The two investigators independently screened the literatures and extracted required data with the inclusion and exclusion criteria,and used the Newcastle-Ottawa Scale?NOS?or modified Jadad scale to evaluate the quality of the eligible trials.Statistical software Stata 12.0 was used in this meta-analysis.Results:A total of 12 eligible trials containing 1057 patients were included,in which 466patients received TACE combined iodine-125 implantation?research group?while the other591 patients are TACE alone?control group?.Meta-analysis revealed that the research group had advantages in 6-month?OR=4.23,95%CI:[3.19,5.62],P<0.001?,1-year?OR=4.75,95%CI:[3.49,6.46],P<0.001?and 2-year?OR=11.12,95%CI:[2.45,50.55],P=0.002?survival rate over control group,which demonstrated a statistically difference.The research group had advantages in intrahepatic tumor therapeutic response?OR=1.73,95%CI:[1.22,2.46],P=0.002?and the objective response rate?ORR?of PVTT over control group,which demonstrated a statistically difference.The average number of TACE treatments in the research group was more than that in the control group?WMD=0.52,95%CI:[0.32,0.73],P<0.001?,which demonstrated a statistically difference.The incidence of gastrointestinal bleeding after operation was lower in the research group than that in the control group?OR=0.09,95%CI:[0.03,0.28],P<0.001?,which demonstrated a statistically difference.However the difference between both groups in terms of Adverse events?such as fever,nausea,vomiting,abdominal pain and abnormal liver function?were not statistically difference?P>0.05?.Conclusion:TACE combined iodine-125 seeds implantation is safe and effective for HCC patients with PVTT,which can significantly improve the survival rate and the ORR of intrahepatic tumor and PVTT.