Efficacy and safety of particle therapy for hepatocellular carcinoma: a meta-analysis

Abstract

Abstract: Objective:To evaluate the efficacy and safety of proton and heavy ion therapy for hepatocellular carcinoma (HCC).
Method:Medline, Embase, Web of Science, China Biology Medicine (CBM), Wanfang Database and China National Knowledge Internet (CNKI) were systematically searched from inception to July 2022. Two researchers independently screened the titles and abstracts, extracted the data, and evaluated the methodological quality of the included studies. STATA 14.0 software was used for meta-analysis.
Result:Totally 13 proton irradiation and 8 carbon ion irradiation which included 1884 patients were included in our final research. The results of meta-analysis showed that carbon ion and proton irradiation could achieve higher long-term local control (LC) rates {5-year LC rate: 90% [95%(confidence interval, CI): 86%-94%], 85% (95%CI: 80%-91%)} and long-term overall survival (OS) rates for HCC [5-year OS rate: 33% (95%CI: 23%-43%), 41% (95%CI: 32%-50%)]. The results of subgroup analysis showed that HCC patients with small tumor diameter, Child-Pugh grade A, primary treatment and single tumor could achieve better survival outcomes, and the incidence of grade 3 or higher adverse events was low.
Conclusion:Proton and heavy ion therapy offer high local control, acceptable overall survival and a low recurrence rate for HCC. However, the existing literature is of low quality and incomplete reporting, especially on toxicity. Therefore, there is a strong need for more prospective, multicenter, and high-quality studies.

Key words: Hepatocellular carcinoma, Carbon ion, Proton, Meta-analysis

Liu Ruifeng¹, Wang Dandan², Zhang Qiuning¹, Luo Hongtao³, Dong Meng², Wang Xiaohu^1,*. Efficacy and safety of particle therapy for hepatocellular carcinoma: a meta-analysis[J]. Electronic Journal of Liver Tumor, 2022, 9(4): 32-45.

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