Doxorubicin‐eluting beads versus conventional transarterial chemoembolization for the treatment of hepatocellular carcinoma

Abstract Background and Aim Doxorubicin‐eluting bead transarterial chemoembolization ( DEB‐TACE ) is a novel locoregional treatment for unresectable hepatocellular carcinoma ( HCC ). However, to date, the benefits of DEB‐TACE versus conventional transarterial chemoembolization ( TACE ) remain unclear. This meta‐analysis was conducted to evaluate the efficacy and safety of the two treatments for patients with unresectable HCC . Methods We searched for relevant articles by means of computerized bibliographic search and complementary manual search. Objective tumor response, overall survival, and adverse events were then calculated and analyzed. Results A total of seven clinical studies with 700 participants were included in the current meta‐analysis. Significantly better objective tumor response was found for DEB‐TACE than for conventional TACE ( OR = 1.92, 95% CI [1.34, 2.77]; P = 0.0004), with relative risk difference of 0.15 [0.07, 0.24] ( P = 0.0003). One‐year and 2‐year survival rates were statistically significantly higher for DEB‐TACE compared with conventional TACE (Peto OR, 95% CI: 0.64 [0.46, 0.89], P = 0.007; 0.61 [0.47, 0.80], P = 0.0003, respectively). Peto ORs of 6‐month and 3‐year survival were 0.72 [0.46, 1.14] ( P = 0.16) and 0.77 [0.55, 1.06] ( P = 0.11), respectively, showing no difference statistically. However, we could still find a tendency favoring DEB‐TACE . Adverse side effects were similar in both groups, with postembolization syndrome occurring most commonly. Conclusions This meta‐analysis shows that DEB‐TACE provides significantly better tumor response compared with conventional TACE . One‐year and 2‐year survival are better with DEB‐TACE . In addition, DEB‐TACE is as safe as conventional TACE . Therefore, DEB‐TACE is a better choice for HCC patients for whom curative treatments like liver transplantation and liver resection are not suitable.