Doxorubicin-eluting bead versus conventional TACE for unresectable hepatocellular carcinoma: a meta-analysis.

BACKGROUND/AIMS Doxorubicin-eluting bead TACE (DEB-TACE) has recently been developed as a novel therapy option for HCC. However, the clinical efficacy of DEB-TACE is still unclear. Herein, we performed a meta-analysis to evaluate the efficacy of DEB-TACE compared with conventional TACE (cTACE). METHODOLOGY We inlcuded seven studies (a total of 693 patients) to compare DEB-TACE with cTACE. The pooled odds ratios (OR) were calculated using a random or fixed effects model. MEDLINE, EMBASE and the Cochrane Database were searched for articles published from dates of inceptions up to February 20, 2012. Sensitivity analysis and publication bias estimate were also performed to evaluate the potential risk bias in the overall results of pooled analysis. RESULTS The pooled estimates for tumor response of DEB-TACE were not significantly different from those of cTACE, with CR (OR: 1.18; 95%CI: 0.81-1.71; p=0.394), PR (OR: 1.37; 95%CI: 0.94-1.99; p=0.101), SD (OR: 0.88; 95%CI: 0.51-1.51; p=0.637), PD (OR: 0.85; 95%CI: 0.52-1.38; p=0.512), DC (OR: 1.37, 95%CI: 0.95-1.98; p=0.089) and OR (OR: 1.40; 95%CI: 0.97-2.000; p=0.070). CONCLUSIONS The current evidence suggests that DEB-TACE is able to accomplish the same tumor response as cTACE. Although this analysis provides a comprehensive look at published data involving the clinical efficacy of DEB-TACE compared with conventional TACE, additional large scale of randomized-control studies are still needed.