TACE combined with PEI versus TACE alone in the treatment of HCC: a meta-analysis

To assess the evidence for improved outcomes in hepatocellular carcinoma (HCC) with transarterial chemoembolization (TACE) plus percutaneous ethanol injection (PEI). A systematic search of MEDLINE, EMBASE, the Cochrane library, Chinese biomedicine literature database, Chinese scientific full-text database, and Chinese journal full-text database was undertaken for relevant articles. The computer search was supplemented with a manual search of reference lists for all available review articles, primary studies, and books to identify other studies not found in the computer search. The initial search identified seven randomized trials that included 623 patients. Meta-analysis results are as follows: the 6-month, 1-, 2-, and 3-year survival rates were significantly better in patients with the TACE+PEI group than TACE group; in the decline rates of the AFP level and the reduction rates of tumor size (>50%), the TACE+PEI group has better effects than TACE group; as adverse effects, TACE+PEI group has lower incidence rates than TACE group. In patients with HCC, the efficacy of TACE combined with PEI is significantly better than that of TACE alone. Although there is convincing evidence to confirm the results mentioned, they still need to be confirmed by large sample, multicenter, randomized, controlled trials.