Comparison of Radioembolization and Sorafenib for the Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: A Systematic Review and Meta-Analysis of Safety and Efficacy

Korean Journal of Radiology : Official Journal of the Korean Radiological Society
Pyeong Hwa KimSeong Ho Park

Abstract

To compare the safety and efficacy of radioembolization with that of sorafenib for the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). MEDLINE, EMBASE, and Cochrane databases were searched for studies reporting outcomes in patients with HCC and PVTT treated with radioembolization or sorafenib. Meta-analyses of cumulative overall survival (OS) and Kaplan-Meier survival rates according to the time to progression (TTP) and incidence of adverse events (AEs) were performed. Subgroup analyses were conducted on 1-year OS data. Seventeen studies were identified (four involving radioembolization, 10 involving sorafenib, and three comparing both). Pooled OS rates were higher in the radioembolization group, notably at 6 months {76% (95% confidence interval [CI], 64-85%) vs. 54% (95% CI, 45-62%)} and 1 year (47% [95% CI, 38-57%] vs. 24% [95% CI, 18-30%]); TTP was also longer with radioembolization. In patients undergoing radioembolization, the proportion of patients with Eastern Cooperative Oncology Group status 0 (p < 0.0001), Child-Pugh A (p < 0.0001), extrahepatic metastasis (p = 0.0012), and a history of cancer treatment (p = 0.0048) was identified as a significant source of heterogeneity for the 1...Continue Reading

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Citations

Dec 20, 2019·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Yeon Hyeon Choe
Jul 24, 2020·World Journal of Gastrointestinal Oncology·Bao-Jiang LiuRen-Jie Yang
Nov 26, 2020·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Yeon Hyeon Choe
Aug 26, 2021·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Gun Ha KimHeung-Kyu Ko
Oct 26, 2021·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Debnarayan DuttaSurendran Sudhindran

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