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iLIVER 2023, 2(2): 130-141 https://doi.org/10.1016/j.iliver.2023.03.002
Meta-analysis | Open Access | Issue | Published: 24 March 2023

Efficacy and complications of transarterial chemoembolization alone or in combination with different protocols for hepatocellular carcinoma: A Bayesian network meta-analysis of randomized controlled trials

Show Author's Information Jingxin Yana,b,c,d,  Manjun Dengc,d,  Ting Lie,  Changhao Dongf,  Minglan Wangg,  Shunyu Konga,b,  Yingxing Guoa( ),  Haining Fanc,d( )
Department of Interventional Therapy, Affiliated Hospital of Qinghai University, Xining, China
Department of Postgraduate, Qinghai University, Xining, China
Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
Qinghai Province Key Laboratory of Hydatid Disease Research, Xining, China
Department of Postgraduate, Chengdu Medical College, Chengdu, China
School of Medicine, South China University of Technology, Guangzhou, China
Department of Postgraduate, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
Keywords:
Network meta-analysis, TACE, HCC, Bayesian method
Cite this article:
Yan J, Deng M, Li T, et al. Efficacy and complications of transarterial chemoembolization alone or in combination with different protocols for hepatocellular carcinoma: A Bayesian network meta-analysis of randomized controlled trials. iLIVER, 2023, 2(2): 130-141. https://doi.org/10.1016/j.iliver.2023.03.002
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Abstract Full text Electronic supplementary material About this article
Background and aims

Transarterial chemoembolization (TACE) is the standard treatment for most intermediate-to-advanced stage hepatocellular carcinoma. With the ongoing development of interventional therapies, TACE in combination with different protocols is being explored. A network meta-analysis to collect recent evidence in this field is required.

Methods

We searched PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase, Chinese National Knowledge Infrastructure database, Cochrane Library, and Wanfang database from their inception to May 2022 for randomized controlled trials (RCTs) that reported TACE in combination with different protocols for hepatocellular carcinoma.

Results

In total, 67 RCTs assessing eight combination treatments were included. The quality of primary outcomes was from moderate to low. The Bayesian network meta-analysis confirmed that TACE combined with iodine-125 seed implantation had the highest probability of 1-year survival rate and TACE combined with sorafenib had the highest probability of 2-year survival rate. TACE alone had the highest probability of incidence of fever, TACE combined with sorafenib had the highest probability of incidence of pain and TACE combined with percutaneous ethanol injection had the highest probability of incidence of nausea and vomiting.

Conclusion

This Bayesian network meta-analysis found that TACE combined with iodine-125 seed and TACE combined with sorafenib may benefit patients in terms of 1-year survival and 2-year survival, respectively. To confirm this conclusion, high-quality and well-designed RCTs with a larger sample size are needed.


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Abstract
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Electronic supplementary material
About this article

Efficacy and complications of transarterial chemoembolization alone or in combination with different protocols for hepatocellular carcinoma: A Bayesian network meta-analysis of randomized controlled trials

Show Author's information Jingxin Yana,b,c,d, Manjun Dengc,d, Ting Lie, Changhao Dongf, Minglan Wangg, Shunyu Konga,b, Yingxing Guoa( ), Haining Fanc,d( )
Department of Interventional Therapy, Affiliated Hospital of Qinghai University, Xining, China
Department of Postgraduate, Qinghai University, Xining, China
Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China
Qinghai Province Key Laboratory of Hydatid Disease Research, Xining, China
Department of Postgraduate, Chengdu Medical College, Chengdu, China
School of Medicine, South China University of Technology, Guangzhou, China
Department of Postgraduate, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

Abstract

Background and aims

Transarterial chemoembolization (TACE) is the standard treatment for most intermediate-to-advanced stage hepatocellular carcinoma. With the ongoing development of interventional therapies, TACE in combination with different protocols is being explored. A network meta-analysis to collect recent evidence in this field is required.

Methods

We searched PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase, Chinese National Knowledge Infrastructure database, Cochrane Library, and Wanfang database from their inception to May 2022 for randomized controlled trials (RCTs) that reported TACE in combination with different protocols for hepatocellular carcinoma.

Results

In total, 67 RCTs assessing eight combination treatments were included. The quality of primary outcomes was from moderate to low. The Bayesian network meta-analysis confirmed that TACE combined with iodine-125 seed implantation had the highest probability of 1-year survival rate and TACE combined with sorafenib had the highest probability of 2-year survival rate. TACE alone had the highest probability of incidence of fever, TACE combined with sorafenib had the highest probability of incidence of pain and TACE combined with percutaneous ethanol injection had the highest probability of incidence of nausea and vomiting.

Conclusion

This Bayesian network meta-analysis found that TACE combined with iodine-125 seed and TACE combined with sorafenib may benefit patients in terms of 1-year survival and 2-year survival, respectively. To confirm this conclusion, high-quality and well-designed RCTs with a larger sample size are needed.

Keywords: Network meta-analysis, TACE, HCC, Bayesian method

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Received: 24 September 2022
Revised: 26 February 2023
Accepted: 05 March 2023
Published: 24 March 2023
Issue date: June 2023

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© 2023 The Author(s). Tsinghua University Press.

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This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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