Meta-Analysis of Trials Comparing Radioembolization and Chemoembolization for Unresectable HCC Published
October 13, 2016—Findings from a systematic review and meta-analysis comparing clinical outcomes of transarterial radioembolization (TARE) versus transarterial chemoembolization (TACE) to treat unresectable hepatocellular carcinoma (HCC) were published by Laila Lobo, MD, et al in CardioVascular and Interventional Radiology (2016;39:1580–1588).
The investigators performed an online search for studies comparing TARE to TACE from 2005 to present. The primary outcome was the overall survival rate for up to 4 years and secondary outcomes included post-treatment complications and treatment response.
As summarized in CardioVascular and Interventional Radiology, the search strategy yielded 172 studies, of which five met selection criteria. These five studies included 553 patients with unresectable HCC, 284 patients underwent TACE and 269 underwent TARE.
The investigators reported that the meta-analysis showed no statistically significant difference in survival for up to 4 years between the two groups (hazard ratio, 1.06; 95% CI, 0.81–1.46; P = .567). TACE required at least 1 day of hospital stay compared to TARE being mostly an outpatient procedure. TACE was associated with more posttreatment pain than TARE (RR = 0.51; 95% CI, 0.36–0.72; P < .01), but less subjective fatigue reported (RR = 1.68; 95% CI, 1.08–2.62; P < .01).
Additionally, there was no difference between the two groups in the incidence of posttreatment nausea, vomiting, fever, or other complications, nor in partial or complete response rates.
The investigators concluded that TARE appears to be a safe alternative treatment to TACE, with comparable complication profiles and survival rates. Larger prospective randomized trials focusing on patient-reported outcomes and cost–benefit analysis are required to consolidate these results, advised the investigators in CardioVascular and Interventional Radiology.