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Hepatic arterial infusion chemotherapy combined with sorafenib versus sorafenib alone for advanced hepatocellular carcinoma: a systematic review and meta-analysis

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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.

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Authors and Affiliations

  1. Department of Interventional Radiology, Tangdu Hospital, The Air Force Medical University, Xi’an, China

    Shunyu Kong

  2. Department of Interventional Therapy, Qinghai University Affiliated Hospital, Xining, China

    Haidong Yu, Haojie Wang & Jingxin Yan

  3. Department of Ultrasound, Xi’an People’s Hospital, Xi’an, China

    Jiaojiao Song

  4. Department of Hepatopancreatobiliary Surgery, Affiliated Hospital of Qinghai University, Xining, China

    Jingxin Yan

  5. West China Hospital, , Sichuan University, Chengdu, China

    Jingxin Yan

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  1. Shunyu Kong
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  2. Haidong Yu
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  4. Jiaojiao Song
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  5. Jingxin Yan
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Contributions

SK and HW contributed to conceptualization; SK and JY performed validation; SK and HY were involved in writing––original draft preparation; JY and SK were involved in writing—review and editing; SK and JS provided software.

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Correspondence to Jingxin Yan.

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Kong, S., Yu, H., Wang, H. et al. Hepatic arterial infusion chemotherapy combined with sorafenib versus sorafenib alone for advanced hepatocellular carcinoma: a systematic review and meta-analysis. Clin J Gastroenterol 16, 793–802 (2023). https://doi.org/10.1007/s12328-023-01860-4

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  • DOI: https://doi.org/10.1007/s12328-023-01860-4

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