Comparing TACE Plus Iodine-125 With TACE Alone

An analysis of 9 studies has concluded that transarterial chemoembolization (TACE) plus iodine-125 seed results in better clinical outcomes than TACE alone for patients with hepatocellular carcinoma (HCC).

TACE is a recommended effective treatment for patients with advanced HCC, and recent research has suggested that the addition of iodine-125 seed can lead to longer survival and long-term local control. The researchers undertook the current study to assess published studies that compared TACE alone with TACE and iodine-125 seed.

To accomplish this, the authors searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews for studies through January 10, 2018. The primary outcomes were overall survival, adverse events, and response rate, which was defined as the rate of partial atrophy or complete clearance of the tumor lesion. Either a fixed-effects model or random-effects model was used to combine the odds ratios. Only prospective randomized controlled trials or non-randomized controlled trials received full-text review.

Based on those criteria, 9 studies that included 894 patients were selected. Of those patients, 473 received the combined therapy of TACE plus iodine-125 implantation, while 421 patients were treated with only TACE. Analysis indicated that the patients in the combined therapy group had significant improvement in 1-year overall survival (odds ratio = 4.47, 95% confidence intervals (CI): 2.97-6.73) and 2-year overall survival (OR = 4.72, 95% CI: 2.63-8.47).

“No significant publication bias was observed in any of the measured outcomes,” the authors commented.

“Based on these findings, TACE plus iodine-125 implantation achieves better clinical efficacy compared with TACE alone in the treatment of HCC,” they concluded.

Reference

Zhu ZX, Wang XX, Yuan KF, Huang JW, Zeng Y. Transarterial chemoembolization plus iodine-125 implantation for hepatocellular carcinoma: a systematic review and meta-analysis. HPB (Oxford). 2018 May 17. pii: S1365-182X(18)30790-1. doi: 10.1016/j.hpb.2018.03.015. [Epub ahead of print].