title: Sorafenib combined with transarterial chemoembolization in patients with hepatocellular carcinoma: a meta-analysis and systematic review.
abstract: OBJECTIVE
  Combination therapy of sorafenib and transarterial chemoembolization (TACE) has shown benefits in treating advanced hepatocellular carcinoma (HCC). This study evaluated the efficacy and safety of TACE + sorafenib.
  
  
  METHODS
  MEDLINE, the Cochrane Library, EMBASE, and the ISI Web of Knowledge were searched (until 31 December 2013) for studies comparing TACE and TACE + sorafenib in treating patients with advanced HCC. Sensitivity and quality assessments were performed.
  
  
  RESULTS
  Five comparative studies (2 were randomized control trials) that included 899 patients were used in the meta-analysis. Patients treated with TACE + sorafenib had better prognoses in terms of time to progression (TTP) compared to those with TACE + placebo or TACE alone; hazard ratios (HRs) ranged from 0.40 to 0.87, with the combined HR 0.61 (95 % CI 0.39-0.95, p = 0.031). However, the combined HR for overall survival (OS) did not differ significantly between patients treated with TACE + sorafenib and those with TACE + placebo or TACE alone (combined HR = 0.79, 95 % CI = 0.54-1.16, p = 0.235). Sensitivity analysis indicated the findings for TTP may be overly influenced by at least one of the studies.
  
  
  CONCLUSIONS
  In summary, our meta-analysis found that TACE + sorafenib can improve TTP. We did not find the combined therapy improved OS. Additional randomized controlled studies are necessary to further investigate the clinical benefit of TACE + sorafenib in treating advanced HCC.
authors: Department of Digestive Internal Medicine, Gan Nan Medical University Pingxiang Hospital, 128 Guangchang Road, Pingxiang, 337055, Jiangxi, People's Republic of China.|Department of Digestive Internal Medicine, 307 Hospital of PLA, Beijing, People's Republic of China.
authors: Guiliang
authors: G
authors: Wang
authors: Department of Digestive Internal Medicine, 307 Hospital of PLA, Beijing, People's Republic of China.
authors: Yan
authors: Y
authors: Liu
authors: Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, 33612, USA.
authors: Shu-Feng
authors: SF
authors: Zhou
authors: Department of Digestive Internal Medicine, Gan Nan Medical University Pingxiang Hospital, 128 Guangchang Road, Pingxiang, 337055, Jiangxi, People's Republic of China.
authors: Ping
authors: P
authors: Qiu
authors: Department of Digestive Internal Medicine, Gan Nan Medical University Pingxiang Hospital, 128 Guangchang Road, Pingxiang, 337055, Jiangxi, People's Republic of China.
authors: Linfang
authors: L
authors: Xu
authors: Department of Digestive Internal Medicine, Gan Nan Medical University Pingxiang Hospital, 128 Guangchang Road, Pingxiang, 337055, Jiangxi, People's Republic of China.
authors: Ping
authors: P
authors: Wen
authors: Department of Digestive Internal Medicine, Gan Nan Medical University Pingxiang Hospital, 128 Guangchang Road, Pingxiang, 337055, Jiangxi, People's Republic of China.
authors: Jianbo
authors: J
authors: Wen
authors: Laboratory of Shock, Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, 410008, People's Republic of China. xianzhongxiaoxxz@sina.com.
authors: Xianzhong
authors: X
authors: Xiao
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: Combined modality therapy; Liver neoplasms; Meta-analysis; Sorafenib; Systematic review; Therapeutic chemoembolization