PMID- 30799569
OWN - NLM
STAT- MEDLINE
DCOM- 20191230
LR  - 20200309
IS  - 2005-8330 (Electronic)
IS  - 1229-6929 (Print)
IS  - 1229-6929 (Linking)
VI  - 20
IP  - 3
DP  - 2019 Mar
TI  - Comparison of Radioembolization and Sorafenib for the Treatment of Hepatocellular 
      Carcinoma with Portal Vein Tumor Thrombosis: A Systematic Review and 
      Meta-Analysis of Safety and Efficacy.
PG  - 385-398
LID - 10.3348/kjr.2018.0496 [doi]
AB  - OBJECTIVE: To compare the safety and efficacy of radioembolization with that of 
      sorafenib for the treatment of hepatocellular carcinoma (HCC) with portal vein 
      tumor thrombosis (PVTT). MATERIALS AND METHODS: MEDLINE, EMBASE, and Cochrane 
      databases were searched for studies reporting outcomes in patients with HCC and 
      PVTT treated with radioembolization or sorafenib. Meta-analyses of cumulative 
      overall survival (OS) and Kaplan-Meier survival rates according to the time to 
      progression (TTP) and incidence of adverse events (AEs) were performed. Subgroup 
      analyses were conducted on 1-year OS data. RESULTS: Seventeen studies were 
      identified (four involving radioembolization, 10 involving sorafenib, and three 
      comparing both). Pooled OS rates were higher in the radioembolization group, 
      notably at 6 months 76% (95% confidence interval [CI], 64-85%) vs. 54% (95% CI, 
      45-62%) and 1 year (47% [95% CI, 38-57%] vs. 24% [95% CI, 18-30%]); TTP was also 
      longer with radioembolization. In patients undergoing radioembolization, the 
      proportion of patients with Eastern Cooperative Oncology Group status 0 (p < 
      0.0001), Child-Pugh A (p < 0.0001), extrahepatic metastasis (p = 0.0012), and a 
      history of cancer treatment (p = 0.0048) was identified as a significant source 
      of heterogeneity for the 1-year OS. Radioembolization was associated with a lower 
      incidence of grade 3/4 AEs than sorafenib (9% [95% CI, 3-27%] vs. 28% [95% CI, 
      17-43%]). CONCLUSION: Compared with sorafenib, radioembolization is a safer and 
      more effective treatment for HCC with PVTT and is associated with prolonged 
      survival, delayed tumor progression, and fewer grade 3/4 AEs.
CI  - Copyright (c) 2019 The Korean Society of Radiology.
FAU - Kim, Pyeong Hwa
AU  - Kim PH
AUID- ORCID: 0000-0003-4276-8803
AD  - Department of Radiology and Research Institute of Radiology, Asan Medical Center, 
      University of Ulsan College of Medicine, Seoul, Korea.
FAU - Choi, Sang Hyun
AU  - Choi SH
AUID- ORCID: 0000-0002-6898-6617
AD  - Department of Radiology and Research Institute of Radiology, Asan Medical Center, 
      University of Ulsan College of Medicine, Seoul, Korea.
FAU - Kim, Jin Hyoung
AU  - Kim JH
AUID- ORCID: 0000-0002-7300-6396
AD  - Department of Radiology and Research Institute of Radiology, Asan Medical Center, 
      University of Ulsan College of Medicine, Seoul, Korea. m1fenew@daum.net.
FAU - Park, Seong Ho
AU  - Park SH
AD  - Department of Radiology and Research Institute of Radiology, Asan Medical Center, 
      University of Ulsan College of Medicine, Seoul, Korea.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - Korea (South)
TA  - Korean J Radiol
JT  - Korean journal of radiology
JID - 100956096
RN  - 0 (Antineoplastic Agents)
RN  - 9ZOQ3TZI87 (Sorafenib)
SB  - IM
MH  - Antineoplastic Agents/adverse effects/*therapeutic use
MH  - Carcinoma, Hepatocellular/complications/*diagnosis/drug therapy/therapy
MH  - *Chemoembolization, Therapeutic/adverse effects
MH  - Diarrhea/etiology
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Liver Neoplasms/complications/*diagnosis/drug therapy/therapy
MH  - Severity of Illness Index
MH  - Sorafenib/adverse effects/*therapeutic use
MH  - Venous Thrombosis/complications/*diagnosis
PMC - PMC6389804
OTO - NOTNLM
OT  - Hepatocellular carcinoma
OT  - Meta-analysis
OT  - Portal vein tumor thrombosis
OT  - Radioembolization
OT  - Sorafenib
COIS- The authors have no potential conflicts of interest to disclose.
EDAT- 2019/02/26 06:00
MHDA- 2019/12/31 06:00
PMCR- 2019/03/01
CRDT- 2019/02/26 06:00
PHST- 2018/07/26 00:00 [received]
PHST- 2018/11/02 00:00 [accepted]
PHST- 2019/02/26 06:00 [entrez]
PHST- 2019/02/26 06:00 [pubmed]
PHST- 2019/12/31 06:00 [medline]
PHST- 2019/03/01 00:00 [pmc-release]
AID - 20.385 [pii]
AID - 10.3348/kjr.2018.0496 [doi]
PST - ppublish
SO  - Korean J Radiol. 2019 Mar;20(3):385-398. doi: 10.3348/kjr.2018.0496.