. Radiology. 2002 Jul;224(1):47-54.Transarterial chemoembolization for unresectable hepatocellular carcinoma:meta-analysis of randomized controlled trials.Cammà C, Schepis F, Orlando A, Albanese M, Shahied L, Trevisani F, Andreone P,Craxì A, Cottone M.National Council of Research, Istituto Metodologie Diagnostiche Avanzate,Palermo, Italy. firstname.lastname@example.orgComment in Radiology. 2003 May;227(2):611-2; author reply 612-3. Radiology. 2004 Jan;230(1):300-1; author reply 301-2.PURPOSE: To review the available evidence of chemoembolization for unresectablehepatocellular carcinoma (HCC).MATERIALS AND METHODS: Computerized bibliographic searches with MEDLINE andCANCERLIT databases from 1980 through 2000 were supplemented with manualsearches, with the keywords "hepatocellular carcinoma," "liver cell carcinoma,""randomized controlled trial [RCT]," and "chemoembolization." Studies wereincluded if patients with unresectable HCC were enrolled and if they were RCTs inwhich chemoembolization was compared with nonactive treatment (five RCTs) or ifdifferent transarterial modalities of therapy (13 RCTs) were compared. Data were extracted from each RCT according to the intention-to-treat method. Five of theRCTs with a nonactive treatment arm were combined by using the random-effectsmodel, whereas all 18 RCTs were pooled from meta-regression analysis.RESULTS: Chemoembolization significantly reduced the overall 2-year mortalityrate (odds ratio, 0.54; 95% CI: 0.33, 0.89; P =.015) compared with nonactivetreatment. Analysis of comparative RCTs helped to predict that overall mortality was significantly lower in patients treated with transarterial embolization (TAE)than in those treated with transarterial chemotherapy (odds ratio, 0.72; 95% CI: 0.53, 0.98; P =.039) and that there is no evidence that transarterialchemoembolization is more effective than TAE (odds ratio, 1.007; 95% CI: 0.79,1.27; P =.95), which suggests that the addition of an anticancer drug did notimprove the therapeutic benefit.CONCLUSION: In patients with unresectable HCC, chemoembolization significantlyimproved the overall 2-year survival compared with nonactive treatment, but themagnitude of the benefit is relatively small.
|Stato di pubblicazione||Published - 2004|
All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging