ABSTRACT
The clinical benefits and safety of hepatic arterial infusion chemotherapy (HAIC) combined with sorafenib versus sorafenib alone for advanced HCC are inconsistent in clinical studies. This meta-analysis aims to evaluate the effectiveness and safety of HAIC combined with sorafenib versus sorafenib alone for advanced hepatocellular carcinoma (HCC). We searched the database up to March 1, 2023, for studies evaluating the effectiveness and safety of HAIC combined with sorafenib versus sorafenib alone for advanced HCC. This study was registered in PROSPERO (CRD42022323712). Outcomes included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), diseases control rate (DCR), and adverse effects (AEs). The hazard ratio (HR) and odd ratio (OR) with 95% confidence intervals (CI) were used to measure the pooled effect. Six studies with 318 patients in the combination group and 338 patients in the control group were included. Meta-analysis showed that HAIC combined with sorafenib significantly improves OS compared with sorafenib alone (HR = 9.70, 95% CI 4.52-20.82] and HAIC combined with sorafenib significantly improves PFS compared with sorafenib alone (HR = 9.48, 95% CI 4.47-20.13). Besides, HAIC combined with sorafenib did not show significantly advantage of DCR rate (OR = 1.85, 95% CI 0.93-3.69), but associated with higher rates of ORR compared with sorafenib alone (OR = 9.85, 95% CI 3.05-31.85). HAIC combined with sorafenib can achieve a better effect and survival benefits than sorafenib alone in patients with advanced HCC, but the limitation should be treated with cautions.
Subject(s)
Carcinoma, Hepatocellular , Liver Neoplasms , Humans , Carcinoma, Hepatocellular/drug therapy , Carcinoma, Hepatocellular/pathology , Sorafenib/adverse effects , Liver Neoplasms/drug therapy , Liver Neoplasms/pathology , Treatment Outcome , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Infusions, Intra-Arterial/adverse effectsABSTRACT
The aim of this study was to investigate a serodiagnostic model as a substitute for liver stiffness measurement (LSM) for diagnosing compensated liver cirrhosis (LC). This retrospective study included 150 patients with compensated hepatitis B-related LC and 153 with chronic Hepatitis B virus (HBV) infection. It was conducted from May 2017 to June 2022 at Qinghai University Affiliated Hospital, China. The values of LSM, aspartate transaminase-to-platelet ratio index (APRI), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), and fibrosis-4 (FIB-4) were evaluated in all admitted patients. The diagnostic value of APRI, GPR, FIB-4, and LSM was assessed using the receiver operating characteristic (ROC) curve. FIB-4 score (AUC=0.842; specificity=77.8%; sensitivity=80.7%; cut-off=2.824) was the best substitute for LSM from the three serum scoring models. The Cox regression model indicated that a FIB-4 score ≥2.824 was an independent predictor of prognosis for compensated hepatitis B-related LC (HR=1.15, 95%CI: 1.07-1.23, p<0.001). This study's findings suggested that FIB-4 could be the best substitute for LSM and may help to assess LC prognosis. Key Words: APRI, GPR, FIB-4, LSM, Diagnosis, Liver cirrhosis.
Subject(s)
Hepatitis B, Chronic , Liver Cirrhosis , Humans , Aspartate Aminotransferases , Biomarkers , Fibrosis , gamma-Glutamyltransferase , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/diagnosis , Liver Cirrhosis/diagnosis , Platelet Count , Prognosis , Retrospective Studies , ROC Curve , Severity of Illness IndexABSTRACT
BACKGROUND: We carried out a systematic review and meta-analysis to assess the safety and effectiveness of hepatic arterial infusion chemotherapy (HAIC) compared with transarterial chemoembolization (TACE) for patients with unresectable hepatocellular carcinoma (uHCC). METHODS: Eligible studies were searched by MEDLINE, the Cochrane Library, Embase, and Web of Science from January 1995 to January 2022, investigating eligible literature comparing HAIC and TACE for patients with HCC. The main outcome measures included progression-free survival (PFS), overall survival (OS), adverse events (AEs), objective response rate (ORR), and diseases control rate (DCR). RESULTS: Eight literature and 1028 patients were enrolled in this meta-analysis. The pooled PFS, OS, ORR, and DCR were HR = 0.89 (95% CI, 0.81-0.98), HR = 0.84 (95% CI, 0.75-0.93), OR = 2.77 (95% CI, 2.01-3.80), and OR = 4.64 (95% CI, 2.40-8.99), respectively. The adverse events of HAIC were lower than TACE. CONCLUSION: Our meta-analysis revealed that HAIC can achieve a better effect and survival benefits than TACE in patients with uHCC.
