Radioembolization versus chemoembolization for unresectable hepatocellular carcinoma: a meta-analysis of randomized trials

Abstract

Andrea Casadei Gardini,1,* Emiliano Tamburini,2,* Mercedes Iñarrairaegui,3 Giovanni Luca Frassineti,1 Bruno Sangro3 1Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e Cura dei Tumori (IRST) IRCCS, Meldola, Italy; 2Department of Medical Oncology, Ospedale Infermi, Rimini, Italy; 3Liver Unit, Clínica Universidad de Navarra-IDISNA and CIBEREHD, Pamplona, Spain *These authors contributed equally to this work Purpose: This study aimed to compare clinically relevant outcomes following transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) in patients with unresectable hepatocellular carcinoma (HCC) using only prospective randomized clinical trials as a source of information.Materials and methods: A meta-analysis was performed to compare the efficacy of TARE and TACE in treating patients with unresectable HCC. Only prospective randomized trials were included in the quantitative analysis. Overall and progression-free survival, disease control rate, and transplantation rate were the variables under analysis.Results: Overall survival at 1 year was similar between the two treatment groups (OR =1.31, 95% CI: 0.56–3.04, P=0.53). Progression-free survival at 1 year was also not statistically different between the two treatments (OR =0.23, 95% CI: 0.02–2.45, P=0.22). Although a higher proportion of patients underwent transplantation in the TARE group (30% vs 20.8%), this difference was not statistically significant (OR =0.68, 95% CI: 0.23–2.01; P=0.49).Conclusion: TARE and TACE provide similar outcomes in unresectable HCC. The role of TARE should be explored in selected patient subpopulations in future clinical trials. Keywords: selective internal radiation, SIRT, TARE, TACE, outcome, transplantation rate