The Clinical Efficacy And Safety Of DEB-TACE And CTACE In The Treatment Of Advanced Hepatocellular Carcinoma:a Meta Analysis

BackgroundPrimary liver cancer is one of the highest incidence malignant tumors in China.Most of the symptoms and signs are in the advanced stage and can not be treated with radical therapy.Transarterial chemoembolization(TACE)is recognized as an effective treatment for advanced hepatocellular carcinoma.In recent years,drug-eluting beads(DEB)have been used in TACE,but there is still debate about the efficacy and safety of drug-eluting beads transarterial chemoembolization(DEB-TACE)and conventional transarterial chemoembolization(cTACE)for advanced hepatocellular carcinoma.ObjectThis study provides a reference to make clinical decisions by comparing the efficacy and safety of DEB-TACE and cTACE in the treatment of advanced hepatocellular carcinoma.MethodsPubmed,Embase,Cochrane library,CNKI,Wan Fang and VIP database were searched by computer for studies of DEB-TACE vs cTACE in the treatment of advanced advanced hepatocellular carcinoma.The retrieval period was from the establishment of the database to June 2020.Stata 15.1 software was used for meta-analysis.The outcomes were complete response rate(CRR),partial response rate(PRR),stable disease rate(SDR),progressive disease rate(PDR),objective response rate(ORR),disease control rate(DCR),1-year survival rates,2-year survival rate and adverse reaction rate.ResultsThe study included 14 randomized controlled trails,a total of 1508 patients with advanced hepatocellular carcinoma,with 743 of whom were in DEB-TACE group and 765 were in cTACE group.The DEB-TACE group had a significantly higher number of CRR(RR=1.43,95%CI:1.08-1.48,P=0.003),PRR(RR=1.28,95%CI:1.11-1.48,P=0.001),ORR(RR=1.26,95%CI:1.44-2.46,P=0.000),DCR(RR=1.13,95%CI:1.04-1.22,P=0.004),1-year survival rate(RR=1.18,95%CI:1.07-1.30,P=0.001)and 2-year survival rate(RR=1.22,95%CI:1.06-1.40,P=0.007).The DEB-TACE group had a significantly lower number of SDR(RR=0.73,95%CI:0.62-0.86,P=0.000),PDR(RR=0.49,95%CI:0.37-0.63,P=0.000)than those in the cTACE group.The differences were statistically significant(P<0.05).There was no statistical difference in the adverse reaction rate between the two groups(P>0.05).ConclusionThe efficacy of DEB-TACE in the treatment of advanced liver cancer was better than that of cTACE.There was no significant safety difference between the two treatment methods.