Comparison of Transarterial Y90 Radioembolization and Conventional Transarterial Chemoembolization in Hepatocarcinoma Patients: A Meta-analysis

To compare the efficacy of Yttrium-90 radioembolization and conventional transarterial chemoembolization in the unresectable hepatocellular carcinoma patients, clinical treatment studies on Yttrium-90 radioembolization and conventional transarterial chemoembolization were identified using PubMed. Tumor response, 3 y overall survival rates were analyzed and compared. Seven studies, including 6 case-control studies and one cohort study, published from December 2008 to January 2017, with a total of 1426 patients, were included in this meta-analysis. Subgroup analyses performed by various designs were included in this meta-analysis. An increase in 3 y overall survival rates was observed in Yttrium-90 radioembolization group compared to the conventional transarterial chemoembolization group (overall survival rate=2.03, 95 % CI-1.45, 2.84, p<0.0001). In contrast, there was no significant difference in tumor response between Yttrium-90 radioembolization and conventional transarterial chemoembolization groups. However, subgroup analysis indicated higher overall tumor control (overall survival rate=2.18, 95 % CI- 1.30, 3.64, p=0.003) in Yttrium-90 radioembolization group. The current meta-analysis suggested that Yttrium-90 radioembolization is associated with significantly higher 3 y overall survival rate. Using the subgroup analysis, the meta-analysis demonstrated higher overall tumor control in the Yttrium-90 radioembolization group.