6.

Trial Sequential Analysis of transcatheter arterial chemoembolisation (TACE) followed by three‐dimensional conformal radiotherapy (3‐DCRT)T versus TACE alone for primary hepatocellular carcinoma with the primary outcome of three‐year all‐cause mortality. The blue line (Z‐curve) shows the cumulative meta‐analysis adding the results of individual trials based on the year of publication. The horizontal green line represents the 2.5% level of significance. The monitoring boundaries (inward sloping red line) show the significance level adjusting for the cumulative analysis. The vertical red line shows the required information size (the number of participants needed to determine if firm evidence was established). We conducted the Trial Sequential Analysis with the alpha set to 5%, power to 80%, control group event rate to 85%, relative risk reduction to 20%, and heterogeneity correction based on model variance. The diversity‐adjusted required information size was 237 participants. The cumulative Z‐curve crossed the monitoring boundary before reaching the heterogeneity‐adjusted information size. In total, the cumulative meta‐analysis included 279 participants in the TACE followed by 3‐DCRT group and 273 in the TACE alone group. The cumulative Z‐curve also crossed the monitoring boundary before reaching the heterogeneity adjusted information size when we increased the power to 90%. DARIS: Distributed and Reflective Informatics System.