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. 系統綜述和薈萃分析優先報告的條目: PRISMA 聲明. 中西醫結合學報, 2009, 7(9): 889-896.
4.	含笑, 呂維富. 經肝動脈化療栓塞聯合射頻消融治療原發性肝癌遠期療效的薈萃分析. 介入放射學雜志, 2013, 22(5): 387-391.
5.	尹建, 呂天石, 關海濤, 等. TACE 聯合 RFA 與單純 RFA 治療肝細胞癌療效與安全性比較的 Meta 分析. 中國介入影像與治療學, 2017, 14(10): 606-612.
6.	熊琨, 白飛, 陳丹妮, 等. 中國原發性肝癌肝動脈化療栓塞術和射頻消融聯合治療與單獨治療的有效性和安全性比較. 中國衛生資源, 2018, 21(3): 271-274, 279.
7.	溫路, 吳忠均, 沈艾, 等. 射頻消融聯合經肝動脈化療栓塞治療肝癌的療效與安全性系統評價. 重慶醫科大學學報, 2014, 39(7): 908-914.
8.	孫賢俊, 何勝利, 沈婕, 等. 射頻消融聯合經動脈化療栓塞治療肝癌的療效分析. 中國臨床醫學, 2011, 18(6): 803-808.
9.	倪嘉延, 劉姍姍, 許林鋒, 等. 原發性肝癌 TACE 與 RFA 聯合治療臨床研究的 Meta 分析. 中華腫瘤防治雜志, 2013, 20(18): 1441-1445.
10.	李安妮, 劉強. 選擇性經肝動脈化療栓塞聯合射頻消融治療原發性肝癌遠期療效的 meta 分析. 肝臟, 2019, 24(12): 1440-1442.
11.	黃燁. 肝臟不同血流阻斷方式對兔肝射頻消融的影響及肝動脈化療栓塞聯合射頻消融治療肝癌的 Meta 分析. 重慶: 陸軍軍醫大學, 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.	白飛云, 李慶元, 沈紅霞, 等. 經動脈導管化療栓塞術聯合射頻消融術治療肝細胞癌的臨床療效分析. 中國臨床醫生雜志, 2022, 50(7): 820-823.
18.	于曉雙, 石娜, 毛中鵬, 等. 經動脈化療栓塞聯合射頻消融法治療對較大原發性肝癌療效分析. 解放軍醫藥雜志, 2019, 31(5): 30-34.
19.	郭杰, 王新娟, 李素賢. 射頻消融聯合同步 TACE 治療老年肝癌的療效. 中國老年學雜志, 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.	劉雅莉, 袁金秋, 楊克虎, 等. 系統評價再評價的制作方法簡介及相關資料分析. 中國循證兒科雜志, 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. 系統綜述和薈萃分析優先報告的條目: PRISMA 聲明. 中西醫結合學報, 2009, 7(9): 889-896.
4. 含笑, 呂維富. 經肝動脈化療栓塞聯合射頻消融治療原發性肝癌遠期療效的薈萃分析. 介入放射學雜志, 2013, 22(5): 387-391.
5. 尹建, 呂天石, 關海濤, 等. TACE 聯合 RFA 與單純 RFA 治療肝細胞癌療效與安全性比較的 Meta 分析. 中國介入影像與治療學, 2017, 14(10): 606-612.
6. 熊琨, 白飛, 陳丹妮, 等. 中國原發性肝癌肝動脈化療栓塞術和射頻消融聯合治療與單獨治療的有效性和安全性比較. 中國衛生資源, 2018, 21(3): 271-274, 279.
7. 溫路, 吳忠均, 沈艾, 等. 射頻消融聯合經肝動脈化療栓塞治療肝癌的療效與安全性系統評價. 重慶醫科大學學報, 2014, 39(7): 908-914.
8. 孫賢俊, 何勝利, 沈婕, 等. 射頻消融聯合經動脈化療栓塞治療肝癌的療效分析. 中國臨床醫學, 2011, 18(6): 803-808.
9. 倪嘉延, 劉姍姍, 許林鋒, 等. 原發性肝癌 TACE 與 RFA 聯合治療臨床研究的 Meta 分析. 中華腫瘤防治雜志, 2013, 20(18): 1441-1445.
10. 李安妮, 劉強. 選擇性經肝動脈化療栓塞聯合射頻消融治療原發性肝癌遠期療效的 meta 分析. 肝臟, 2019, 24(12): 1440-1442.
11. 黃燁. 肝臟不同血流阻斷方式對兔肝射頻消融的影響及肝動脈化療栓塞聯合射頻消融治療肝癌的 Meta 分析. 重慶: 陸軍軍醫大學, 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. 白飛云, 李慶元, 沈紅霞, 等. 經動脈導管化療栓塞術聯合射頻消融術治療肝細胞癌的臨床療效分析. 中國臨床醫生雜志, 2022, 50(7): 820-823.
18. 于曉雙, 石娜, 毛中鵬, 等. 經動脈化療栓塞聯合射頻消融法治療對較大原發性肝癌療效分析. 解放軍醫藥雜志, 2019, 31(5): 30-34.
19. 郭杰, 王新娟, 李素賢. 射頻消融聯合同步 TACE 治療老年肝癌的療效. 中國老年學雜志, 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. 劉雅莉, 袁金秋, 楊克虎, 等. 系統評價再評價的制作方法簡介及相關資料分析. 中國循證兒科雜志, 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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