title: Evaluation of drug-eluting beads versus conventional transcatheter arterial chemoembolization in patients with unresectable hepatocellular carcinoma: A systematic review and meta-analysis.
abstract: OBJECTIVE
  Transcatheter arterial chemoembolization (TACE) is the first-line treatment for unresectable hepatocellular carcinoma (HCC). It consists of conventional TACE (cTACE) and drug-eluting beads TACE (DEB-TACE). The comparative outcomes of the two methods remain controversial. The study aim to research the optimal TACE strategy for unresectable HCC.
  
  
  METHODS
  A systematic search of keywords, including 'HCC' and 'drug-eluting beads' was performed including four electronic databases: PubMed, Embase, China Biological Medicine Database (CBM), and Cochrane library databases from the date of inception to December 25, 2015. Review Manager 5.3 was used to calculate the pooled relative risks (RRs) and 95% confident intervals (CIs).
  
  
  RESULTS
  Sixteen cohort studies (4 RCTs, 3 prospective cohorts, 9 retrospective cohorts) were included comprising a total of 1832 patients: 822 patients with DEB-TACE therapy and 1010 patients undergoing cTACE. The 1-, 2-, and 3-year overall survival (OS) rates and 1- and 2-year relapse-free survival (RFS) rates were significantly higher in DEB-TACE group, with pooled RRs of 1.12 (95% CI=1.03-1.23, P=0.007), 1.26 (95% CI=1.03-1.54, P=0.02), 1.69 (95% CI=1.00-2.84, P=0.04), 1.21 (95% CI=1.01-1.44, P=0.03) and 1.68 (95% CI=1.17-2.43, P=0.005). There was no statistical significance in 3-year RFS, tumor response and treatment-related adverse events.
  
  
  CONCLUSIONS
  Compared with cTACE, DEB-TACE therapy significantly improved 1-, 2-, and 3-year OS rates and the 1- and 2-year RFS rates.
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230000, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230000, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Yuan
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230000, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230000, China.
authors.forename: Jingchang
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230000, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Shen
authors.affiliation: Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230000, China. Electronic address: qianyeben@hotmail.com.
authors.forename: Yeben
authors.initials: Y
authors.lastname: Qian
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology; D057785:Catheters; D016461:Chemoembolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D016503:Drug Delivery Systems; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008863:Microspheres; D012107:Research Design; D016896:Treatment Outcome