Transarterial chemoembolization for unresectable hepatocellular carcinoma: Meta-analysis of randomized controlled trials
| Autor: | Mario Cottone, Antonio Craxì, Ambrogio Orlando, Lillian Shahied, Calogero Cammà, Filippo Schepis, Maddalena Albanese, Pietro Andreone, Franco Trevisani |
|---|---|
| Předmět: |
medicine.medical_specialty
Carcinoma Hepatocellular medicine.medical_treatment Gastroenterology law.invention Randomized controlled trial law Internal medicine Carcinoma Medicine Humans Radiology Nuclear Medicine and imaging Embolization Chemoembolization Therapeutic Survival rate Randomized Controlled Trials as Topic business.industry Liver cell Liver Neoplasms medicine.disease Clinical trial Survival Rate Treatment Outcome Meta-analysis Hepatocellular carcinoma Radiology Safety business Hepatocellular Chemoembolization Therapeutic |
| Zdroj: | Scopus-Elsevier |
| Popis: | To review the available evidence of chemoembolization for unresectable hepatocellular carcinoma (HCC).Computerized bibliographic searches with MEDLINE and CANCERLIT databases from 1980 through 2000 were supplemented with manual searches, with the keywords "hepatocellular carcinoma," "liver cell carcinoma," "randomized controlled trial [RCT]," and "chemoembolization." Studies were included if patients with unresectable HCC were enrolled and if they were RCTs in which chemoembolization was compared with nonactive treatment (five RCTs) or if different transarterial modalities of therapy (13 RCTs) were compared. Data were extracted from each RCT according to the intention-to-treat method. Five of the RCTs with a nonactive treatment arm were combined by using the random-effects model, whereas all 18 RCTs were pooled from meta-regression analysis.Chemoembolization significantly reduced the overall 2-year mortality rate (odds ratio, 0.54; 95% CI: 0.33, 0.89; P =.015) compared with nonactive treatment. Analysis of comparative RCTs helped to predict that overall mortality was significantly lower in patients treated with transarterial embolization (TAE) than in those treated with transarterial chemotherapy (odds ratio, 0.72; 95% CI: 0.53, 0.98; P =.039) and that there is no evidence that transarterial chemoembolization is more effective than TAE (odds ratio, 1.007; 95% CI: 0.79, 1.27; P =.95), which suggests that the addition of an anticancer drug did not improve the therapeutic benefit.In patients with unresectable HCC, chemoembolization significantly improved the overall 2-year survival compared with nonactive treatment, but the magnitude of the benefit is relatively small. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|