TACE with portal vein radioactive seeds for HCC with portal vein tumor thrombus: a meta-analysis

Abstract

Purpose

To assess the efficacy and safety of transarterial chemoembolization (TACE) and portal vein radioactive seed insertion (RSI) combination in hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).

Material and methods

The relevant databases were searched from the earliest to January 2021. The endpoints included treatment response, treatment side effects, and overall survival (OS).

Results

Nine studies were included in this meta-analysis. The pooled total response (TR, p = 0.55) and disease control (DC, p = 0.13) rates for HCC were similar between the two treatment groups. The pooled TR (p = 0.0004) and DC (p < 0.0001) rates for PVTT were both significantly higher in the TACE with portal vein RSI group than in the TACE without portal vein RSI group. The pooled HR for OS was significantly better in the TACE with portal vein RSI group than in the TACE without portal vein RSI group (p < 0.00001). The pooled rates of fever (p = 0.97), vomiting (p = 0.64), and myelosuppression (p = 0.65) were similar between the two groups.

Conclusion

Compared to traditional TACE, TACE combined with portal vein RSI can effectively prolong the patients’ OS and decrease PVTT disease progression.

Keywords:

• Hepatocellular carcinoma
• portal vein tumor thrombus
• radioactive seed
• transcatheter arterial chemoembolization
• meta-analysis

Disclosure statement

No potential conflict of interest was reported by the authors.