title: 3D conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma.
abstract: OBJECTIVE
  To compare transcatheter arterial chemoembolization (TACE) and 3D conformal radiotherapy (3D-CRT) with TACE monotherapy in hepatocellular carcinoma (HCC).
  
  
  METHODS
  We searched all the eligible studies from the Cochrane Library, PubMed, Medline, Embase, and CNKI. The meta-analysis was performed to assess the survival benefit, tumor response, and the decline in α-fetoprotein (AFP) level. According to the heterogeneity of the studies, pooled OR with 95%CI were calculated using the fixed-effects or random-effects model. An observed OR > 1 indicated that the addition of 3D-CRT to TACE offered survival benefits to patients that could be considered statistically significant. Statistical analyses were performed using Review Manager Software.
  
  
  RESULTS
  Ten studies met the criteria to perform a meta-analysis including 908 HCC participants, with 400 patients in the TACE/3D-CRT combination group and 508 in the TACE alone group. TACE combined with 3D-CRT significantly improved 1-, 2- and 3-year overall survival compared with TACE monotherapy (OR = 1.87, 95%CI: 1.37-2.55, P < 0.0001), (OR = 2.38, 95%CI: 1.78-3.17, P < 0.00001) and (OR = 2.97, 95%CI: 2.10-4.21, P < 0.00001). In addition, TACE plus 3D-CRT was associated with a higher tumor response (complete remission and partial remission) (OR = 3.81; 95%CI: 2.70-5.37; P < 0.00001), and decline rates of AFP level (OR = 3.24, 95%CI: 2.09-5.02, P < 0.00001).
  
  
  CONCLUSIONS
  This meta-analysis demonstrated that TACE combined with 3D-CRT was better than TACE monotherapy for patients with HCC, which needs to be confirmed by large multicenter trials．
authors.affiliation: Li-Qun Zou, Bing-Lan Zhang, Yan-Yan Li, Yu-Quan Wei, Yong-Song Guan, Department of Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Zou
authors.affiliation: Li-Qun Zou, Bing-Lan Zhang, Yan-Yan Li, Yu-Quan Wei, Yong-Song Guan, Department of Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Bing-Lan
authors.initials: BL
authors.lastname: Zhang
authors.affiliation: Li-Qun Zou, Bing-Lan Zhang, Yan-Yan Li, Yu-Quan Wei, Yong-Song Guan, Department of Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Chang
authors.affiliation: Li-Qun Zou, Bing-Lan Zhang, Yan-Yan Li, Yu-Quan Wei, Yong-Song Guan, Department of Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Fu-Ping
authors.initials: FP
authors.lastname: Zhu
authors.affiliation: Li-Qun Zou, Bing-Lan Zhang, Yan-Yan Li, Yu-Quan Wei, Yong-Song Guan, Department of Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: Li
authors.affiliation: Li-Qun Zou, Bing-Lan Zhang, Yan-Yan Li, Yu-Quan Wei, Yong-Song Guan, Department of Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Yu-Quan
authors.initials: YQ
authors.lastname: Wei
authors.affiliation: Li-Qun Zou, Bing-Lan Zhang, Yan-Yan Li, Yu-Quan Wei, Yong-Song Guan, Department of Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Yong-Song
authors.initials: YS
authors.lastname: Guan
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016009:Chi-Square Distribution; D018450:Disease Progression; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016017:Odds Ratio; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012074:Remission Induction; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: C097353:AFP protein, human; D000509:alpha-Fetoproteins
keywords: Chemoembolization; Hepatocellular carcinoma; Meta-analysis; Three-dimensional conformal radiotherapy