Evaluation on Efficacy and Safety of Arsenic Trioxide Plus Transcatheter Arterial Chemoembolization Versus Transcatheter Arterial Chemoembolization alone for Unresectable Primary Liver Cancer

Abstract

<br /> <span style="font-size: small;">Currently, some clinical trials of arsenic trioxide (As203) plus transcatheter arterial chemoembolization (TACE) in the treatment of unresectable primary liver cancer (PLC) had been conducted, but the results were controversial. </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Therefore, we performed a meta-analysis on 14 clinical trials (1076 cases) to evaluate efficacy and safety of As203 </span></span><span style="font-size: small;">plus TACE versus TACE alone for unresectable PLC. The primary end points included objective response rate (ORR), karnofsky performance score (KPS) improvement rate, and 1-year survival rate. The second end points were adverse events consisting of leukopenia, liver dysfunction, nausea/vomiting, fever, myelosuppression and pain. Our study </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">showed that, compared with TACE alone, As203 plus TACE appeared a significant benefit on ORR (RR = 1.32, 95% CI: 1.15,1.50, P < 0.0001), KPS improvement rate (RR = 1.24, 95% CI: 1.03,1.48, P = 0.02) and 1-year survival rate (RR = 1.31, 95% CI: 1.15,1.49, P < 0.0001). Additionally, no remarkable difference of adverse events were observed between two arms: leukopenia (RR = 1.44, 95% CI: 0.90,2.32, P = 0.13), liver dysfunction (RR = 0.96, 95% CI: 0.76,1.21, P = 0.71), nausea/vomiting (RR = 1.10, 95% CI: 0.84,1.44, P = 0.48), fever (RR = 1.15, 95% CI: 0.82,1.61, P = 0.43), myelosuppression (RR = 1.07, 95% CI: 0.74,1.56, P = 0.72) and pain (RR = 0.88, 95% CI: 0.57,1.36, P = 0.57). This study demonstrated that As203 plus TACE produced a favorable efficacy without enhancing adverse events and was a </span></span><span style="font-size: small;">promising combination therapy option for unresectable PLC. </span>