Table 1.
Baseline characteristics of studies included in the network meta-analysis
| Study and treatment | Study quality | Study design | Propensity score matching | Child–Pugh score | ECOG PS | Vascular invasion | Serum AFP ≥400 ng/mL (n) | End point outcome used | Toxicity ≥ grade 3 | I2 |
|---|---|---|---|---|---|---|---|---|---|---|
| TACE + sorafenib vs TACE or sorafenib alone | 18% | |||||||||
| 1. Choi et al,27 Korea; TACE + sorafenib (=164); sorafenib alone (n=191) | High | Retrospective | Yes | A/B: 119/45; A/B: 136/55 | NA | PVTT + extrahepatic meta | 83; 104 | OS, DCR | Leucopenia: 6 vs 3; hand–foot: 29 vs 23 | |
| 2. Bai et al,28 China; TACE + sorafenib (=82); TACE alone (n=146) | High | Prospective non-RCT | Yes | A/B: 63/19; A/B: 163/59 | 0/1/2/3: 30/38/12/1/1; 0/1/2/3: 85/119/18/0/0 | MVI + extrahepatic metastasis | NA | OS, DCR | Hand–foot: 2 vs 0; diarrhea: 4 vs 0 | |
| TACE vs sorafenib alone | ||||||||||
| 3. Pinter et al,29 Austria; TACE alone (n=34); sorafenib alone (n=63) | High | Retrospective | No | A/B: 20/14; A/B: 28/35 | 0/≥1: 9/25; 0/≥1: 21/42 | MVI + extrahepatic metastasis | 8; 19 | OS, DCR | Leucopenia: 2 vs 1; hand–foot: 0 vs 2 | |
| TACE + 3D-RT vs TACE | 0% | |||||||||
| 4. Li et al,30 China; TACE + RT (n=108); TACE alone (n=108) | High | Retrospective | Yes | A/B: 102/6; A/B: 105/3 | NA | PVTT + extrahepatic metastasis | 66; 61 | OS, DCR | NA | |
| 5. Lu et al,31 China; TACE + RT (n=30); TACE alone (n=33) | High | Retrospective | No | A/B: 20/10; A/B: 21/12 | NA | PVTT + extrahepatic meta | 12; 11 | OS, DCR | NA | |
| 6. Koo et al,32 Korea; TACE + RT (n=42); TACE alone (n=29) | High | Prospective | No | A/B: 26/16; A/B: 17/12 | 0–2 | IVCTT | ≤1,000 ng/mL; 22; 14 | OS, DCR | NA | |
| HAIC + 3D-RT vs HAIC alone | 17% | |||||||||
| 7. Chuma et al,21 Japan; HAIC + RT (n=20); HAIC alone (n=20) | Moderate | Retrospective | No | A/B: 15/5; A/B: 13/7 | NA | PVTT | NA | OS, DCR | Leucopenia: 3 vs 2 | |
| 8. Fujino et al,19 Japan; HAIC + RT (n=41); HAIC alone (n=42) | High | Retrospective | No | A/B/C: 19/14/8; A/B/C: 14/18/10 | 0/1: 37/4; 0/1: 35/7 | PVTT | 464; 1,742 | OS, DCR | Leucopenia: 5 vs 6; thrombocytopenia: 5 vs 6 | |
| 9. Katamura et al,22 Japan; HAIC + RT (n=16); HAIC alone (n=16) | Moderate | Prospective | No | A/B: 12/4; A/B: 13/3 | NA | PVTT | 184.8; 586.7 | OS, DCR | Leucopenia: 9 vs 3; thrombocytopenia: 6 vs 5 | |
| 10. Onishi et al,20 Japan; HAIC + RT (n=33); HAIC alone (n=34) | High | Retrospective | No | B: 16; B: 16 | NA | PVTT | 575; 399 | OS, DCR | Blood bile increase: 3 vs 2; leucopenia: 15 vs 2 | |
| Sorafenib alone vs HAIC alone | 0% | |||||||||
| 11. Jeong et al,33 Korea; HAIC alone (n=21); sorafenib alone (n=20) | High | Retrospective | No | A/B: 10/11; A/B: 14/6 | 1/2: 19/2; 1/2: 16/4 | PVTT + extrahepatic meta | 12; 13 | OS, DCR | Neutropenia: 5 vs 0; thrombocytopenia: 6 vs 0; hand–foot: 0 vs 2 | |
| 12. Kawaoka et al,34 Japan; HAIC alone (n=136); sorafenib alone (n=41) | Moderate | Retrospective | No | A: 136; A: 41 | NA | MVI | Median: 415.3; 136 | OS, DCR | Liver failure: 3 vs 0; hand–foot: 0 vs 2 | |
| 13. Song et al,35 Japan; HAIC alone (n=136); sorafenib alone (n=41) | High | Retrospective | No | A/B: 45/4; A/B: 47/13 | NA | PVTT + extrahepatic meta | Serum AFP ≥200 ng/mL; 32 vs 51 | OS, DCR | Hematologya: 106 vs 0; diarrhea: 0 vs 13 | |
| SBRT + TACE vs SBRT | 0% | |||||||||
| 14. Kang et al,36 China; SBRT + TACE (n=71); SBRT (n=30) | Moderate | Retrospective | No | A/B: 48/19; A/B: 24/11 | NA | PVTT | 27; 9 | OS, DCR | NA | |
| 15. Sapir et al,37 USA TACE (n=84); SBRT (n=125) | Moderate | Retrospective | Yes | A: 84; 125 | <2: 142/95; ≤2: 24; 25 | PVTT | NA | OS, DCR | Hypervolemia: 3 vs 1; GI and biliary: 2 vs 7 | |
| Pooled data | 19% | |||||||||
Note:
a
Hematology in HAIC group: leucopenia (36), neutropenia (46), anemia (72), and thrombocytopenia (56).
Abbreviations: AFP, alpha-fetoprotein; DCR, disease control rate; ECOG PS, Eastern Cooperative Oncology Group Performance Status; GI, gastrointestinal; HAIC, hepatic arterial infusion chemotherapy; IVCTT, inferior vena cava tumoral thrombosis; MVI, macrovascular invasion; OS, overall survival; PVTT, portal vein tumor thrombus; RCT, randomized controlled trial; SBRT, stereotactic body radiotherapy; TACE, transarterial chemoembolization; 3D-RT, three-dimensional radiotherapy; NA, not available; RT, radiotherapy.