Radiofrequency ablation combined with transcatheter arterial chemoembolization for primary liver cancer: an overview of systematic reviews_West China Medical Journal

Authors：

SUN Tong ^1,2 , HU Shiping ² , WANG Xin ³ , LI Feng ^1,2 ,  RAN Yun ²

1. Beijing University of Chinese Medicine, Beijing, 100029, P. R. China;
2. Department of Hepatology, Shenzhen Hospital (Longgang), Beijing University of Chinese Medicine, Shenzhen, Guangdong 518100, P. R. China;
3. Department of Dermatology, the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan 410000, P. R. China;

Corresponding author：

RAN Yun, Email: 35540785@qq.com

Keywords：

Liver cancer; radiofrequency ablation; transcatheter arterial chemoembolization; overview of systematic reviews

DOI：

10.7507/1002-0179.202302008

Video：

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Objective To overview the systematic reviews/meta-analyses of radiofrequency ablation combined with transcatheter arterial chemoembolization for primary liver cancer. Methods We searched China National Knowledge Infrastructure, Wanfang, Chongqing VIP, SinoMed, PubMed, Embase, and Web of Science databases using computers, with a search deadline of December 31, 2022 for systematic reviews/meta-analyses of radiofrequency ablation combined with transcatheter arterial chemoembolization for primary liver cancer. The AMSTAR 2 scale, PRISMA statement, and GRADE grading system were used to evaluate the reporting quality, methodological quality, and evidence level. Results A total of 13 systematic reviews/meta-analyses were included, published from 2011 to 2022. The evaluation results of the AMSTAR 2 scale showed that 4 systematic reviews/meta-analyses were of low quality, while the rest were of extremely low quality, without medium to high quality systematic reviews/meta-analyses. The evaluation results of PRISMA statement showed that the scores of 9 systematic reviews/meta-analyses were 15-21, with certain reporting defects, and only 4 were relatively complete. The GRADE system evaluation of 75 evidence bodies for 9 clinical outcome indicators showed that there was no high quality of evidence, with medium quality accounting for 29%, low quality accounting for 32%, and extremely low quality accounting for 39%. Conclusions Radiofrequency ablation combined with transcatheter arterial chemoembolization can improve the 1-year and 3-year overall survival rates of patients with primary liver cancer with medium quality of evidence. However, its impact on 5-year overall survival rate, recurrence-free survival rate, complications, and whether it is more effective for hepatocellular carcinoma with a diameter of 3-5 cm still require more high-quality clinical research and systematic evaluation to verify.

Citation： SUN Tong, HU Shiping, WANG Xin, LI Feng, RAN Yun. Radiofrequency ablation combined with transcatheter arterial chemoembolization for primary liver cancer: an overview of systematic reviews. West China Medical Journal, 2023, 38(8): 1211-1218. doi: 10.7507/1002-0179.202302008 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
3.	Moher D, Liberati A, Tetzlaff J, 等. 系统综述和荟萃分析优先报告的条目: PRISMA 声明. 中西医结合学报, 2009, 7(9): 889-896.
4.	含笑, 吕维富. 经肝动脉化疗栓塞联合射频消融治疗原发性肝癌远期疗效的荟萃分析. 介入放射学杂志, 2013, 22(5): 387-391.
5.	尹建, 吕天石, 关海涛, 等. TACE 联合 RFA 与单纯 RFA 治疗肝细胞癌疗效与安全性比较的 Meta 分析. 中国介入影像与治疗学, 2017, 14(10): 606-612.
6.	熊琨, 白飞, 陈丹妮, 等. 中国原发性肝癌肝动脉化疗栓塞术和射频消融联合治疗与单独治疗的有效性和安全性比较. 中国卫生资源, 2018, 21(3): 271-274, 279.
7.	温路, 吴忠均, 沈艾, 等. 射频消融联合经肝动脉化疗栓塞治疗肝癌的疗效与安全性系统评价. 重庆医科大学学报, 2014, 39(7): 908-914.
8.	孙贤俊, 何胜利, 沈婕, 等. 射频消融联合经动脉化疗栓塞治疗肝癌的疗效分析. 中国临床医学, 2011, 18(6): 803-808.
9.	倪嘉延, 刘姗姗, 许林锋, 等. 原发性肝癌 TACE 与 RFA 联合治疗临床研究的 Meta 分析. 中华肿瘤防治杂志, 2013, 20(18): 1441-1445.
10.	李安妮, 刘强. 选择性经肝动脉化疗栓塞联合射频消融治疗原发性肝癌远期疗效的 meta 分析. 肝脏, 2019, 24(12): 1440-1442.
11.	黄烨. 肝脏不同血流阻断方式对兔肝射频消融的影响及肝动脉化疗栓塞联合射频消融治疗肝癌的 Meta 分析. 重庆: 陆军军医大学, 2019.
12.	Yu Y, Fu J, Xia P, et al. A systematic review and meta-analysis on the efficacy and safety of transcatheter arterial chemoembolization combined with radiofrequency ablation in the treatment of primary liver cancer. Transl Cancer Res, 2022, 11(5): 1297-1308.
13.	Wang X, Hu Y, Ren M, et al. Efficacy and safety of radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular carcinomas compared with radiofrequency ablation alone: a time-to-event meta-analysis. Korean J Radiol, 2016, 17(1): 93-102.
14.	Lu Z, Wen F, Guo Q, et al. Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: a meta-analysis of randomized-controlled trials. Eur J Gastroenterol Hepatol, 2013, 25(2): 187-194.
15.	Liu Z, Gao F, Yang G, et al. Combination of radiofrequency ablation with transarterial chemoembolization for hepatocellular carcinoma: an up-to-date meta-analysis. Tumour Biol, 2014, 35(8): 7407-7413.
16.	Chen QW, Ying HF, Gao S, et al. Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: a systematic review and meta-analysis. Clin Res Hepatol Gastroenterol, 2016, 40(3): 309-314.
17.	白飞云, 李庆元, 沈红霞, 等. 经动脉导管化疗栓塞术联合射频消融术治疗肝细胞癌的临床疗效分析. 中国临床医生杂志, 2022, 50(7): 820-823.
18.	于晓双, 石娜, 毛中鹏, 等. 经动脉化疗栓塞联合射频消融法治疗对较大原发性肝癌疗效分析. 解放军医药杂志, 2019, 31(5): 30-34.
19.	郭杰, 王新娟, 李素贤. 射频消融联合同步 TACE 治疗老年肝癌的疗效. 中国老年学杂志, 2015, 35(17): 4870-4871.
20.	Veltri A, Moretto P, Doriguzzi A, et al. Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable non-early hepatocellular carcinoma (HCC). Eur Radiol, 2006, 16(3): 661-669.
21.	刘雅莉, 袁金秋, 杨克虎, 等. 系统评价再评价的制作方法简介及相关资料分析. 中国循证儿科杂志, 2011, 6(1): 58-64.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
3. Moher D, Liberati A, Tetzlaff J, 等. 系统综述和荟萃分析优先报告的条目: PRISMA 声明. 中西医结合学报, 2009, 7(9): 889-896.
4. 含笑, 吕维富. 经肝动脉化疗栓塞联合射频消融治疗原发性肝癌远期疗效的荟萃分析. 介入放射学杂志, 2013, 22(5): 387-391.
5. 尹建, 吕天石, 关海涛, 等. TACE 联合 RFA 与单纯 RFA 治疗肝细胞癌疗效与安全性比较的 Meta 分析. 中国介入影像与治疗学, 2017, 14(10): 606-612.
6. 熊琨, 白飞, 陈丹妮, 等. 中国原发性肝癌肝动脉化疗栓塞术和射频消融联合治疗与单独治疗的有效性和安全性比较. 中国卫生资源, 2018, 21(3): 271-274, 279.
7. 温路, 吴忠均, 沈艾, 等. 射频消融联合经肝动脉化疗栓塞治疗肝癌的疗效与安全性系统评价. 重庆医科大学学报, 2014, 39(7): 908-914.
8. 孙贤俊, 何胜利, 沈婕, 等. 射频消融联合经动脉化疗栓塞治疗肝癌的疗效分析. 中国临床医学, 2011, 18(6): 803-808.
9. 倪嘉延, 刘姗姗, 许林锋, 等. 原发性肝癌 TACE 与 RFA 联合治疗临床研究的 Meta 分析. 中华肿瘤防治杂志, 2013, 20(18): 1441-1445.
10. 李安妮, 刘强. 选择性经肝动脉化疗栓塞联合射频消融治疗原发性肝癌远期疗效的 meta 分析. 肝脏, 2019, 24(12): 1440-1442.
11. 黄烨. 肝脏不同血流阻断方式对兔肝射频消融的影响及肝动脉化疗栓塞联合射频消融治疗肝癌的 Meta 分析. 重庆: 陆军军医大学, 2019.
12. Yu Y, Fu J, Xia P, et al. A systematic review and meta-analysis on the efficacy and safety of transcatheter arterial chemoembolization combined with radiofrequency ablation in the treatment of primary liver cancer. Transl Cancer Res, 2022, 11(5): 1297-1308.
13. Wang X, Hu Y, Ren M, et al. Efficacy and safety of radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular carcinomas compared with radiofrequency ablation alone: a time-to-event meta-analysis. Korean J Radiol, 2016, 17(1): 93-102.
14. Lu Z, Wen F, Guo Q, et al. Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: a meta-analysis of randomized-controlled trials. Eur J Gastroenterol Hepatol, 2013, 25(2): 187-194.
15. Liu Z, Gao F, Yang G, et al. Combination of radiofrequency ablation with transarterial chemoembolization for hepatocellular carcinoma: an up-to-date meta-analysis. Tumour Biol, 2014, 35(8): 7407-7413.
16. Chen QW, Ying HF, Gao S, et al. Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: a systematic review and meta-analysis. Clin Res Hepatol Gastroenterol, 2016, 40(3): 309-314.
17. 白飞云, 李庆元, 沈红霞, 等. 经动脉导管化疗栓塞术联合射频消融术治疗肝细胞癌的临床疗效分析. 中国临床医生杂志, 2022, 50(7): 820-823.
18. 于晓双, 石娜, 毛中鹏, 等. 经动脉化疗栓塞联合射频消融法治疗对较大原发性肝癌疗效分析. 解放军医药杂志, 2019, 31(5): 30-34.
19. 郭杰, 王新娟, 李素贤. 射频消融联合同步 TACE 治疗老年肝癌的疗效. 中国老年学杂志, 2015, 35(17): 4870-4871.
20. Veltri A, Moretto P, Doriguzzi A, et al. Radiofrequency thermal ablation (RFA) after transarterial chemoembolization (TACE) as a combined therapy for unresectable non-early hepatocellular carcinoma (HCC). Eur Radiol, 2006, 16(3): 661-669.
21. 刘雅莉, 袁金秋, 杨克虎, 等. 系统评价再评价的制作方法简介及相关资料分析. 中国循证儿科杂志, 2011, 6(1): 58-64.

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Radiofrequency ablation combined with transcatheter arterial chemoembolization for primary liver cancer: an overview of systematic reviews

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