Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: A systematic review and meta-analysis

Chen, Qi Wen; Ying, Hai; Gao, Song; Ye, Shen; Meng, Zhi Qiang; Chen, Hao; Chen, Zhe; Teng, Wen Jing

doi:10.1016/j.clinre.2015.07.008

Cited by 72 publications

(50 citation statements)

References 27 publications

(41 reference statements)

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“…Another very recent RCT [42] showed that TACE-RFA was superior to RFA alone in improving survival for patients with HCC <7 cm. Moreover, several independent meta-analyses [43,44,45,46], including the RCTs available for RFA plus TACE compared with RFA alone, confirmed high-quality evidence suggesting that TACE in combination with RFA improved survival outcomes compared with RFA alone for patients with HCC, particularly for tumors >3 cm in size. An alternative strategy using localized radiation in combination with RFA has also been studied [47].…”

Section: Local Ablative Therapymentioning

confidence: 79%

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

Shi

Zhai

2016

Gastrointest Tumors

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Background: Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the third most common cause of cancer-related deaths. Hepatic resection and liver transplantation are considered to be the preferred treatment for HCC. However, as novel therapeutic options such as image-guided locoregional therapies have emerged and been refined, the manner in which HCC is treated has changed dramatically compared with what it was considered just 2 decades earlier. Summary: This study reviews the current results of various image-guided locoregional therapies for treating HCC, especially focusing on thermal ablative and transarterial techniques. Key Message: Advances in image-guided locoregional therapies, including local ablative therapy and transarterial therapy, have led to a major breakthrough in the management of HCC. Both survival rates and cure rates of patients with HCC have improved markedly since the introduction of these techniques. Practical Implications: Radiofrequency ablation is currently considered as an alternative to surgical resection for patients with early-stage HCC. A newer technique of ablation such as microwave ablation is increasingly being used, especially for large HCC. Transarterial chemoembolization has become a standard care for asymptomatic patients with multinodular tumors in intermediate-stage disease, and transarterial radioembolization has become the method of choice in HCC cases with portal vein thrombosis. Moreover, combination treatment modalities, such as thermal-based ablation combined with transarterial chemoembolization or ¹²⁵I seed implant brachytherapy, may further broaden their clinical indications for HCC. Moreover, use of localized radiation in combination with thermal ablation has been reported to improve tumor control and long-term survival.

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Section: Local Ablative Therapymentioning

confidence: 79%

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

Shi

Zhai

2016

Gastrointest Tumors

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“…Complications associated with TACE, including an impaired hepatic functional reserve, support the use of RFA rather than repeated TACE treatments (22,23). Emerging evidence suggests that a combination of TACE and RFA exerts a synergistic anticancer activity against HCC, particularly for larger lesions that do not respond sufficiently to either TACE or RFA treatments alone (24)(25)(26). An analysis of the factors that carry a high risk of early recurrence following TACE may improve the selection of patients suited to a combination of TACE with RFA.…”

Section: Discussionmentioning

confidence: 99%

Predisposing factors for hepatocellular carcinoma recurrence following initial remission after transcatheter arterial chemoembolization

et al. 2017

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Abstract. Hepatocellular carcinoma (HCC) is prone to recurrence following curative treatment. The purpose of the present study was to identify the predisposing factors of HCC recurrence following complete remission achieved by transarterial chemoembolization (TACE). A retrospective cohort study of 70 consecutive patients with HCC who underwent TACE as the initial treatment was conducted. The patients were divided into two groups according to their 1-year disease-free survival (DFS) status; the early recurrence group (ER group; n=32), with HCC recurring within 1 year of initial TACE; and the non-early recurrence group (NER group; n=38), who did not experience recurrence within 1 year. The parameters identified as significantly associated with DFS time on univariate analysis were aspartate aminotransferase (AST), alanine aminotransferase and α-fetoprotein levels, as well as the tumor number (P=0.003, P=0.027, P=0.002 and P=0.005, respectively). Multivariate analysis revealed that AST levels and tumor number were significantly associated with a shorter DFS period (P=0.009 and P=0.038, respectively). The Mantel-Haenszel test revealed a significant trend of decreasing DFS with increasing tumor number. Among the patients with HCC in the ER group, locoregional recurrence occurred more frequently in those who received TACE alone compared with those treated with TACE combined with radiofrequency ablation treatment. In summary, multinodularity of HCC is the most potent predictive factor for the recurrence of HCC within 1 year of initial TACE.

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“…Through the protection of liver function and regulation of body immunity, TCM can also improve the patient's quality of life (QOL) and reduce adverse reactions [25,26]. In some cases, if long-term using TCM treatment, HCC could be completely regressed and the patient remains alive longer than 31 months after relapse [27]. Additionally, hepatic fibrosis, cirrhosis and rate of HCC occurrence in patients have been significantly inhibited [28,29].…”

Section: Treatment Of Hcc Using Tcm Alone or In Combination With Othementioning

confidence: 99%

“…The results showed that with both, TCM had a positive effect in the treatment of HCC. Although direct use of TCM by hepatic artery perfusion/embolization has a good effect [96,97], multimodal treatment strategy, such as RFA + TACE [98], radiofrequency ablation + TACE + hepatectomy [99], TCM+ WM+ intervention [100], is more effective than that of interventional therapy alone for patients. Additionally, multimodal treatment can be used as a helpful bridging therapy for patients who are waiting for liver transplantation.…”

Section: Combination Of Tcm and Interventional Therapy For Treatment mentioning

confidence: 99%

Traditional Chinese medicine combined with other therapies for treatment of hepatocellular carcinoma in clinical trials

Feng¹,

Zhu²,

Hu³

et al. 2017

Cancer Rep Rev

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Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide with a high mortality, and still there are only few effective methods to treat it. To this end, alternative medicines from traditional Chinese medicine (TCM) are being investigated for their ability to eliminate the tumor or halt its progression. A large number of studies have shown that TCM can be an effective approach to treat the HCC in clinical trials when used alone or in combination with other therapies. Thus, TCM has made significant progress, and has begun to gain worldwide popularity for promoting healthcare and HCC treatment. Because of this progress, periodic summaries are needed to facilitate further research for the use of TCM to treat HCC. This paper provides a comprehensive summary of this work with regard to the following aspects: herbalist views on the etiology and therapeutic principles for treatment of HCC, treating HCC by TCM alone, treating HCC with TCM in combination with resection, chemotherapy, radiotherapy and interventional therapy, and other therapies. Additionally, the current main problems and future application prospects for treatment of HCC by TCM described, which could provide scientific guidance for clinician as well as references for the treatment of other cancers.

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Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: A systematic review and meta-analysis

Abstract: TACE combined with RFA was more effective than RFA alone, especially for treatment for intermediate and large-size hepatic tumours or younger patients with HCC.

Cited by 72 publications

References 27 publications

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

A Recent Advance in Image-Guided Locoregional Therapy for Hepatocellular Carcinoma

Predisposing factors for hepatocellular carcinoma recurrence following initial remission after transcatheter arterial chemoembolization

Traditional Chinese medicine combined with other therapies for treatment of hepatocellular carcinoma in clinical trials

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