The efficacy and safety of transcatheter arterial chemoembolization combined with lenvatinib plus radiotherapy in the treatment of hepatocellular carcinoma: a meta-analysis

Background: transcatheter arterial chemoembolization (TACE) is the standard treatment for advanced and unresectable hepatocellular carcinoma (HCC) patients.Lenvatinib (LVTN) is one of the novel oral antiangiogenic drugs demonstrating promising application prospects, which has been widely concerned and studied.This work was to systematically analyze efficacy and safety of TCAE combined with LVTN plus radiotherapy (RT) on HCC through the meta-analysis.Materials and Methods: a comprehensive search was conducted on PubMed, Web of Science, Embase, and The Cochrane Library databases from January 2000 to the present to identify studies examining the effectiveness and safety of combining TCAE with LVTN and RT for the treatment of HCC.Relevant literature was screened, and essential information along with evaluation indicators were extracted for analysis.RevMan5.3 was employed for quality assessment and meta-analysis of the included studies, and forest maps (FMs) were drawn.Results: five studies were included.Meta-analysis showed that TCAE combined with LVTN plus RT enhanced the total objective response rate (ORR) of HCC (OR = 3.16, 95%CI = 1.37-7.32,P < 0.05).TCAE combined with LVTN plus RT enhanced the total survival (OS) rate of HCC patients (OR = 2.01, 95%CI=1.30-3.12,P < 0.05).TCAE combined with LVTN plus RT could reduce the diarrhea rate greatly (OR = 2.84, 95%CI = 1.16-6.96,P< 0.05).However, no observable difference was found in the incidence of hypertension caused by TCAE combined with LVTN plus RT (OR = 2.39, 95%CI = 0.62-9.23,P > 0.05).Conclusion: LVTN combined with TACE had superior efficacy on HCC compared with non-LVTN combined with TCAE, but the related side effects (SEs) may affect the scope of application and the quality of life of patients.