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Transcatheter hepatic arterial infusion chemotherapy vs sorafenib in the treatment of patients with hepatocellular carcinoma of Barcelona Clinic Liver Cancer stage C: a meta-analysis of Asian population

Authors Ni JY, Liu SS, Sun HL, Wang WD, Zhong ZL, Hou SN, Chen YT, Xu LF

Received 12 November 2017

Accepted for publication 6 July 2018

Published 6 November 2018 Volume 2018:11 Pages 7883—7894


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Samir Farghaly

Jia-Yan Ni,1,* Shan-Shan Liu,2,* Hong-Liang Sun,1 Wei-Dong Wang,1 Ze-Long Zhong,1 Si-Nan Hou,1 Yao-Ting Chen,1 Lin-Feng Xu1

1Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Interventional Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, People’s Republic of China; 2Department of Public Health, Sushe Community Health Service Center, Guangzhou 510220, Guangdong Province, People’s Republic of China

*These authors contributed equally to this work

Objective: To compare the clinical efficacy and safety of transcatheter hepatic arterial infusion chemotherapy (HAIC) with those of sorafenib in the treatment of patients with hepatocellular carcinoma (HCC) of Barcelona Clinic Liver Cancer (BCLC) stage C.
Methods: Potentially relevant studies comparing the clinical efficacy and safety of HAIC with those of sorafenib were searched using Medline, PubMed, Embase, Cochrane Library, and Chinese databases (Wanfang Data and China National Knowledge Infrastructure). Overall survival rate (OSR), tumor response rate, disease control rate (DCR), and serious adverse events (SAEs) were compared and analyzed. Pooled ORs with 95% CIs were calculated using either the fixed-effects model or the random-effects model. All statistical analyses were conducted using Review Manager (version 5.3) from the Cochrane Collaboration.
Results: A total of 1,264 patients were included in this meta-analysis. The results of this study showed that HAIC was associated with significantly higher 1-, 2-, and 3-year OSRs than sorafenib (OR 1.88, 95% CI1-year: [1.27–2.78], P1-year=0.002; OR 2.15, 95% CI2-year: [1.06–4.37], P2-year=0.03; OR 7.90, 95% CI3-year: [2.12–29.42], P3-year=0.002). Compared to sorafenib, HAIC was associated with superior complete response (CR), partial response (PR), and objective response rate (ORR) (OR 3.90, 95% CICR: [1.89–8.03], PCR =0.0002; OR 3.47, 95% CIPR: [2.31–5.24], PPR <0.00001; OR 3.02, 95% CIOR: [2.05–4.45], POR <0.0001). There was no statistically significant difference between HAIC and sorafenib in stable disease (SD), progressive disease (PD), DCR, and SAEs (OR 0.86, 95% CISD: [0.51–1.45], PSD =0.56; OR 0.62, 95% CIPD: [0.35–1.11], PPD =0.11; OR 0.53, 95% CISAE: [0.14–1.92], PSAE =0.33).
Conclusion: This study showed that HAIC was associated with better efficacy than sorafenib in terms of OSR and tumor response. Therefore, HAIC can be considered as an alternative treatment option for patients with HCCs of BCLC stage C.

Keywords: HCC, HAIC, targeted therapy, BCLC, prognosis, meta-analysis

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