Efficacy and safety of epirubicin applied in transcatheter arterial chemoembolization for hepatocellular carcinoma: A meta-analysis

Objectives: This study was aimed to evaluate the efficacy and safety of epirubicin applied in transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). Materials and Methods: Studies were searched in Embase, PubMed, and Springer until August 10, 2016. All the studies were screened with inclusion and exclusion criteria. The quality assessment of the eligible studies was performed with the Newcastle-Ottawa Scale and the Jadad Scale. Response rate, recurrence, mortality, and thrombocytopenia were evaluated with risk ratios (RRs) with 95% confidence intervals (CIs). The heterogeneity and publication bias were assessed. Results: Ten eligible studies were included with a total of 993 objects. The data were extracted and summarized. The overall results were calculated including response rate (RR = 0.98, 95% CI: 0.83-1.15), recurrence (RR = 0.75, 95% CI: 0.58-0.96), mortality (RR = 0.71, 95% CI: 0.39-1.28), and thrombocytopenia (RR = 0.42, 95% CI: 0.09-1.93), without significant heterogeneity. There was a significant heterogeneity for mortality; thus, the random effects model was used. No publication bias was observed in this study. Conclusions: The results of meta-analysis indicated that epirubicin applied in TACE has an obvious efficacy for the treatment of HCC, with significantly decreased recurrence while without superiority of safety.