Efficacy of Transarterial Chemoembolization Combined with Tyrosine Kinase Inhibitors for Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus: A Systematic Review and Meta-Analysis

作者全名："Deng, Jia; Liao, Ziyue; Gao, Jian"

作者地址："[Deng, Jia; Liao, Ziyue] Chongqing Med Univ, Clin Coll 2, Chongqing 400000, Peoples R China; [Gao, Jian] Chongqing Med Univ, Affiliated Hosp 2, Dept Gastroenterol, Chongqing 400000, Peoples R China"

通信作者："Gao, J (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Gastroenterol, Chongqing 400000, Peoples R China."

来源：CURRENT ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000914523300001

JCR分区：Q2

影响因子：2.8

年份：2023

卷号：30

期号：1

开始页：1243

结束页：1254

文献类型：Review

关键词：hepatocellular neoplasm (HCC); portal vein tumor thrombus (PVTT); transcatheter chemoembolization (TACE); tyrosine kinase inhibitor (TKI); meta-analysis

摘要："Background: Transarterial chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) may enhance the efficacy of treatment for hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT); however, it remains unclear. We aim to evaluate the efficacy of TACE combined with TKIs. Methods: A thorough literature search was performed on major databases since their inception until October 2022. Based on the eligibility criteria, eight studies (2103 patients) were included. Results: Meta-analysis showed that TACE+sorafenib/apatinib had a better tumor response (objective response rate (ORR): RR = 4.85, 95% CI 2.68-8.75, disease control rate (DCR): RR = 3.23, 95% CI 1.88-5.56), and prolonged OS (HR = 0.50, 95%CI 0.42-0.60, p < 0.00001) than TACE alone. TACE+lenvatinib was stronger than TACE+sorafenib in ORR (60.7% vs. 38.9%) and TTP (HR = 0.61, 95% CI 0.43-0.86), whereas it was similar in DCR (96.4% vs. 96.3%) and OS (HR = 0.70 95% CI 0.46-1.05). Conclusions: TACE plus sorafenib or apatinib was superior to TACE alone for hepatocellular carcinoma with PVTT; no significant advantage was found between TACE+lenvatinib and TACE+sorafenib, although TACE+lenvatinib performed better in terms of ORR and TTP."

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