78 - Transarterial Radioembolization versus Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-analysis

Purpose: To evaluate and compare the safety and efficacy of transarterial radioembolization (TARE) and transarterial chemoembolization (TACE) in the treatment of patients with unresectable hepatocellular carcinoma (HCC).

Materials and Methods: A systematic search of MEDLINE/PubMed, EMBASE, and the Cochrane Library identified studies comparing TARE and TACE for unresectable HCC. Meta-analyses were conducted to evaluate hazard ratios (HRs) for overall survival (OS), progression-free survival (PFS), and time to progression (TTP); risk ratios (RRs) for treatment response, post-procedural pain, major complications, and mortality; and mean difference (MD) in hospital stay. Subgroup and meta-regression analyses were performed for OS.

Results: Twenty-one studies were included. TARE was associated with a significantly higher complete response (CR) rate compared to TACE (RR = 1.23; 95% CI, 1.01–1.51; p = 0.045). The pooled HR for OS was 0.93 (95% CI, 0.76–1.13; p = 0.443), indicating comparable efficacy between TARE and TACE in terms of OS. The pooled HR for PFS was 0.68 (95% CI: 0.45–1.01; p = 0.055), indicating a trend toward improved efficacy of TARE compared to TACE in terms of PFS. TARE was associated with significantly less post-procedural pain (RR = 0.48; 95% CI, 0.27–0.83; p = 0.014) and a shorter hospital stay (MD = –2.77 days; 95% CI, –4.33 to –1.22; p = 0.006). No significant differences were observed in major complications or mortality.

Conclusion: TARE showed comparable OS to TACE, with a higher CR rate and a trend toward improved PFS. Moreover, TARE was associated with less post-procedural pain and a shorter hospital stay, indicating a more favorable tolerability profile.