Open Access

Comparative effectiveness of interventional therapeutic modalities for unresectable hepatocellular carcinoma: A systematic review and network meta‑analysis

  • Authors:
    • Xin‑Long Chen
    • Hai‑Chuan Yu
    • Qi‑Gang Fan
    • Qi Yuan
    • Wen‑Kai Jiang
    • Shao‑Zhen Rui
    • Wen-Ce Zhou
  • View Affiliations

  • Published online on: August 31, 2022     https://doi.org/10.3892/ol.2022.13486
  • Article Number: 366
  • Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

It is unclear whether hepatic artery infusion chemotherapy (HAIC) or transcatheter arterial chemoembolization (TACE) is more efficient in the combination therapy of hepatocellular carcinoma (HCC). Head‑to‑head comparisons among HAIC‑related therapies are lacking. For this network meta‑analysis, PubMed, EMBASE and Cochrane Library databases were searched up to April 1, 2022. Randomized controlled trials (RCTs) were eligible if they evaluated the use or prolongation of TACE or HAIC in patients with advanced HCC and reported or collected survival data. A network meta‑analysis was performed to synthesize data and make direct and indirect comparisons between treatments. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to explore the efficacy of various treatment options on overall survival (OS), odds ratios (ORs) with 95% CI were used for overall response rate (ORR), whereas risk ratios (RRs) with 95% CI were used for serious adverse events (SAEs). The analysis of 7 trials including a total of 1,073 patients found that sorafenib with HAIC‑oxaliplatin improved survival (HR=0.33, 95% CI: 0.25‑0.44); the ORR was also improved in patients treated with sorafenib plus HAIC‑oxaliplatin and sorafenib plus PF‑HAIC (OR=22.18, 95% CI: 10.69‑52.56; and OR=2.72, 95% CI: 1.43‑5.36, respectively). The incidence of liver injury was elevated in patients treated with sorafenib plus TACE (OR=5.93, 95% CI: 2.70‑15.41). However, no differences in the incidences of other SAEs were identified among the treatment groups. The present meta‑analysis provides preliminary evidence for the comparative safety and efficacy of HAIC and TACE combined with sorafenib, and indicates the dominance of HAIC‑oxaliplatin in HCC interventional therapy. However, high‑quality RCTs are required to further confirm the efficacy of HAIC‑oxaliplatin. The present study has been registered with PROSPERO (registration no. CRD42021288497).
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October-2022
Volume 24 Issue 4

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Chen XL, Yu HC, Fan QG, Yuan Q, Jiang WK, Rui SZ and Zhou W: Comparative effectiveness of interventional therapeutic modalities for unresectable hepatocellular carcinoma: A systematic review and network meta‑analysis. Oncol Lett 24: 366, 2022
APA
Chen, X., Yu, H., Fan, Q., Yuan, Q., Jiang, W., Rui, S., & Zhou, W. (2022). Comparative effectiveness of interventional therapeutic modalities for unresectable hepatocellular carcinoma: A systematic review and network meta‑analysis. Oncology Letters, 24, 366. https://doi.org/10.3892/ol.2022.13486
MLA
Chen, X., Yu, H., Fan, Q., Yuan, Q., Jiang, W., Rui, S., Zhou, W."Comparative effectiveness of interventional therapeutic modalities for unresectable hepatocellular carcinoma: A systematic review and network meta‑analysis". Oncology Letters 24.4 (2022): 366.
Chicago
Chen, X., Yu, H., Fan, Q., Yuan, Q., Jiang, W., Rui, S., Zhou, W."Comparative effectiveness of interventional therapeutic modalities for unresectable hepatocellular carcinoma: A systematic review and network meta‑analysis". Oncology Letters 24, no. 4 (2022): 366. https://doi.org/10.3892/ol.2022.13486