Status Quo of Global Interventional Therapy for Tumors: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Yingqiang ¹ , LI Xianglian ¹ ,  LI Youping ¹ , DENG Shaolin ² , LUO Qianqian ³ , WEI Shiyou ²

1. Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu 610041, China;2. West China Medical School, Sichuan University, Chengdu 610041, China;3. National Chengdu Center for Safety Evaluation of Drugs, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LI Youping, Email: yzmylab@163.com

Keywords：

Neoplasm; Interventional therapy; Systematic review; Bibliometrics

DOI：

10.7507/1672-2531.20130183

Video：

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Objective 　To evaluate the trends, dominant diseases and clinical outcomes of the global interventional therapy for tumors based on evidence, so as to provide references for standard access of interventional technology.
Methods 　Such databases as PubMed, EMbase, Web of Science, The Cochrane Library, CBM, CNKI and VIP were electronically and comprehensively searched for relevant clinical or fundamental studies about interventional therapy for tumors from inception to September, 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria and extracted data. Then, descriptive analysis was performed using SPSS 13.0 and Microsoft Excel 2003 software.
Results 　Totally, 4 544 studies were included, consisting of 4 136 (91.0%) clinical studies and 408 (9.0%) fundamental studies. These clinical studies including 155 systematic reviews (SRs), 338 randomized controlled trials (RCTs), 1 191 clinical controlled trials (CCTs), and 2 451 case series or case reports (CSs/CRs). Transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) were the most clinically frequenly-used interventional technologies for tumors, accounting for 32.6% and 17.1% of the total, respectively. Hepatocellular carcinoma (HCC) was the dominant tumor, which was mentioned in 99 SRs (57.6%), 198 RCTs (58.6%), 824 CCTs (69.1%) and 1 191 CSs/CRs (48.6%), following by colorectal liver metastases (CLM). Radiofrequency ablation (RFA) treating HCC resulted in a higher rate of 3-year survival (12 SRs/Meta-analyses) and lower recurrence (10 SRs/Meta-analyses) compared with percutaneous ethanol injection (PEI). Compared with hepatic resection (HR), RFA treating HCC resulted in lower rates of 3-year (11 SRs/Meta-analyses) and 5-year survival (9 SRs/Meta-analyses), and no significant difference was found in 1-year survival between the two groups (17 SRs/Meta-analyses). Preoperative TACE before HR or liver transplantation could not improve the survival for patients with advanced HCC (6 SRs/Meta-analyses), but postoperative TACE might prolong the 1-and 3-year survival (3 SRs/Meta-analyses). TACE combined with other interventional therapy (i.e., RFA, PEI) could also prolong the survival of HCC patients. For the treatment of uterine leiomyoma, uterine artery embolization (UAE) resulted in less hospital duration or operative time, and it caused a higher re-intervention rate, compared with surgery, but it lacked long-term outcomes.
Conclusion 　Interventional therapy is an optional and promising technology for patients with tumors. We should well-consider currently available best clinical evidence as well as local medical facilities or skill level when applying them to clinical practice, so as to perform relevant interventional techniques with scientific, rational and standardized methods.

Citation： WANG Yingqiang,LI Xianglian,LI Youping,DENG Shaolin,LUO Qianqian,WEI Shiyou. Status Quo of Global Interventional Therapy for Tumors: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2013, 13(9): 1060-1072. doi: 10.7507/1672-2531.20130183 Copy

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1. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 2010, 127(12): 2893-2917.
2. Soerjomataram I, Lortet-Tieulent J, Parkin DM, et al. Global burden of cancer in 2008: a systematic analysis of disability-adjusted life-years in 12 world regions. Lancet, 2012, 380(9856): 1840-1850.
3. Kimman M, Norman R, Jan S, et al. The burden of cancer in member countries of the Association of Southeast Asian Nations (ASEAN). Asian Pac J Cancer Prev, 2012, 13(2): 411-420.
4. Bray F, Jemal A, Grey N, et al. Global cancer transitions according to the Human Development Index (2008-2030): a population-based study. Lancet Oncol, 2012, 13(8): 790-801.
5. Gupta JK, Sinha A, Lumsden MA, et al. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev: John Wiley & Sons, Ltd; 2006, (1): CD005073.
6. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med, 2009, 6(7): e1000097.
7. van der Kooij SM, Bipat S, Hehenkamp WJ, et al. Uterine artery embolization versus surgery in the treatment of symptomatic fibroids: a systematic review and metaanalysis. Am J Obstet Gynecol, 2011, 205(4): 317 e1-18.
8. Sud S, Maheshwari A, Bhattacharya S. Obstetric outcomes after treatment of fibroids by uterine artery embolization: a systematic review (Provisional abstract). Expert Rev of Obstet Gynecol, 2009: 429-441.
9. Buyse M. Reappraisal of hepatic arterial infusion in the treatment of nonresectable liver metastases from colorectal cancer. J Natl Cancer Inst, 1996, 88(5): 252-258.
10. Harmantas A, Rotstein LE, Langer B. Regional versus systemic chemotherapy in the treatment of colorectal carcinoma metastatic to the liver. Is there a survival difference? Meta-analysis of the published literature. Cancer, 1996, 78(8): 1639-1645.
11. Mocellin S, Pasquali S, Nitti D. Fluoropyrimidine-HAI (hepatic arterial infusion) versus systemic chemotherapy (SCT) for unresectable liver metastases from colorectal cancer. Cochrane Database Syst Rev: John Wiley & Sons, Ltd; 2009, (3): CD007823.
12. Mathurin P, Raynard B, Dharancy S, et al. Meta-analysis: evaluation of adjuvant therapy after curative liver resection for hepatocellular carcinoma. Aliment Pharmacol Ther, 2003, 17(10): 1247-1261.
13. Marelli L, Stigliano R, Triantos C, et al. Treatment outcomes for hepatocellular carcinoma using chemoembolization in combination with other therapies. Cancer Treat Rev, 2006, 32(8): 594-606.
14. Samuel M, Chow PKH, Shih-Yen EC, et al. Neoadjuvant and adjuvant therapy for surgical resection of hepatocellular carcinoma. Cochrane Database Syst Rev, 2009, (1): CD001199.
15. Chua TC, Liauw W, Saxena A, et al. Systematic review of neoadjuvant transarterial chemoembolization for resectable hepatocellular carcinoma. Liver Int, 2010, 30(2): 166-174.
16. Wang X, Li J, Peng Y, et al. Influence of preoperative transarterial chemoembolization on the prognosis for patients with resectable hepatocellular carcinoma: a meta-analysis of randomized trials. Hepatogastroenterology, 2011, 58(107-108): 869-874.
17. Zhong JH, Li LQ. Postoperative adjuvant transarterial chemoembolization for participants with hepatocellular carcinoma: A meta-analysis. Hepatol Res, 2010, 40(10): 943-953.
18. 马良, 钟鉴宏, 黎乐群, 等. 肝动脉化疗栓塞在肝细胞性肝癌切除术后应用的系统评价. 中国癌症防治杂志, 2011, 3(1): 74-81.
19. 顾国文, 李相成. 肝癌切除术后经肝动脉化疗栓塞对预防复发和提高生存率疗效的系统评价. 南京医科大学学报·自然科学版, 2008, 28(6): 726-732.
20. Oliveri Roberto S, Wetterslev J, Gluud C. Transarterial (chemo)embolisation for unresectable hepatocellular carcinoma. Cochrane Database Syst Rev: John Wiley & Sons, Ltd; 2011.
21. Meng MB, Cui YL, Lu Y, et al. Transcatheter arterial chemoembolization in combination with radiotherapy for unresectable hepatocellular carcinoma: a systematic review and meta-analysis. Radiother Oncol, 2009, 92(2): 184-194.
22. Gu GW, Li XC. [Meta-analysis of the efficacy of transcatheter arterial chemoembolization combined with percutaneous ethanol injection in treating unresectable primary liver cancer][Article in Chinese]. Chinese Medical Journal, 2009, 89(12): 805-809.
23. Wang W, Shi J, Xie WF. Transarterial chemoembolization in combination with percutaneous ablation therapy in unresectable hepatocellular carcinoma: a meta-analysis. Liver Int, 2010, 30(5): 741-749.
24. Wang N, Guan QL, Wang K, et al. TACE combined with PEI versus TACE alone in the treatment of HCC: a meta-analysis. Med Oncol, 2011, 28(4): 1038-1043.
25. 孙贤俊, 何胜利, 沈婕, 等. 射频消融联合经动脉化疗栓塞治疗肝癌的疗效分析. 中国临床医学, 2011, 18(6): 803-808.
26. Xie F, Zang J, Guo X, et al. Comparison of transcatheter arterial chemoembolization and microsphere embolization for treatment of unresectable hepatocellular carcinoma: a meta-analysis. J cancer res clin oncol, 2012, 138(2): 455-462.
27. Meng MB, Cui YL, Guan YS, et al. Traditional Chinese medicine plus transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma. J Altern Complement Med, 2008, 14(8): 1027-1042.
28. Sun QZ, Ma WL, Gao Y, et al. Meta-Analysis: Therapeutic Effect of Transcatheter Arterial Chemoembolization Combined with Compound Kushen Injection in Hepatocellular Carcinoma. Afr J Tradit Complement Alt M, 2012, 9(2): 178-188.
29. Cho W, Chen H. Investigation of the efficacy on transcatheter arterial chemoembolization combined with or without Chinese herbal therapy for hepatocellular carcinoma: Meta-analysis. Eur J Cancer, Supplement, 2009, 7(2-3): 393-394.
30. Martin R, Geller D, Espat J, et al. Safety and efficacy of trans arterial chemoembolization with drug-eluting beads in hepatocellular cancer: a systematic review. Hepatogastroenterology, 2012, 59(113): 255-260.
31. He J, Xie F, Yang J, et al. Transarterial chemoembolization for palliation of unresectable liver metastases from colorectal cancer (Protocol for a systematic review) (Structured abstract). Health Technol Assess, 2010. p. Crd32010000481.
32. Llovet JM, Lencioni R, Di Bisceglie AM, et al. EASL-EORTC Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol, 2012, 56(4): 908-943.
33. Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology, 2011, 53(3): 1020-1022.
34. Galandi D, Antes G. Radiofrequency thermal ablation versus other interventions for hepatocellular carcinoma. Cochrane Database Syst Rev: John Wiley & Sons, Ltd; 2004, (2): CD003046.
35. Lopez PM, Villanueva A, Llovet JM. Systematic review: evidence-based management of hepatocellular carcinoma - an updated analysis of randomized controlled trials. Aliment Pharmacol Ther, 2006, 23(11): 1535-1547.
36. 周泉波, 卢桠楠, 陈汝福, 等. 射频消融与经皮无水乙醇注射治疗小肝癌临床效果比较的系统评价. 中华肝胆外科杂志, 2011, 17(3): 189-193.
37. Zhou YM, Zhao YF, Li B, et al. Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma. BMC Gastroenterol, 2010, 10: 78.
38. Liu JG, Wang YJ, Du Z. Radiofrequency ablation in the treatment of small hepatocellular carcinoma: a meta analysis. World J Gastroenterol, 2010, 16(27): 3450-3456.
39. Liu Z, Zhou Y, Zhang P, et al. Meta-analysis of the therapeutic effect of hepatectomy versus radiofrequency ablation for the treatment of hepatocellular carcinoma (Structured abstract). Surg Laparosc Endosc and Percutan Tech, 2010, 20(3): 130-140.
40. Li L, Zhang JL, Liu XH, et al. Clinical outcomes of radiofrequency ablation and surgical resection for small hepatocellular carcinoma: A meta-analysis. Journal of Gastroenterology and Hepatology, 2012, 27(1): 51-58.
41. Gravante G, Overton J, Sorge R, et al. Radiofrequency ablation versus resection for liver tumours: an evidence-based approach to retrospective comparative studies. J Gastrointest Surg, 2011, 15(2): 378-387.
42. Sutherland LM, Williams JA, Padbury RT, et al. Radiofrequency ablation of liver tumors: a systematic review. Arch Surg, 2006, 141(2): 181-190.
43. Stang A, Fischbach R, Teichmann W, et al. A systematic review on the clinical benefit and role of radiofrequency ablation as treatment of colorectal liver metastases. Eur J Cancer, 2009, 45(10): 1748-1756.
44. Wu YZ, Li B, Wang T, et al. Radiofrequency ablation vs hepatic resection for solitary colorectal liver metastasis: a meta-analysis. World J Gastroenterol, 2011, 17(36): 4143-4148.
45. Khajanchee YS, Hammill CW, Cassera MA, et al. Hepatic resection vs minimally invasive radiofrequency ablation for the treatment of colorectal liver metastases: a Markov analysis. Arch Surg, 2011, 146(12): 1416-1423.
46. Bipat S, van Leeuwen MS, Ijzermans JNM, et al. Evidence-based guideline on management of colorectal liver metastases in the Netherlands. Neth J Med, 2007, 65(1): 5-14.
47. Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolization for major liver resection: A meta-analysis. Ann surg, 2008, 247(1): 49-57.
48. 赵文毅, 罗蒙, 孙勇伟, 等. 肝切除术前门静脉栓塞疗效的荟萃分析. 中华外科杂志, 2008, 46(19): 1460-1464.
49. 赵文毅, 罗蒙, 孙勇伟, 等. 肝切除术前门静脉栓塞对围手术期影响的荟萃分析. 外科理论与实践, 2009, 14(1): 28-32.
50. Warmuth M, Johansson T, Mad P. Systematic review of the efficacy and safety of high-intensity focussed ultrasound for the primary and salvage treatment of prostate cancer. Eur Urol, 2010, 58(6): 803-815.
51. Lukka H, Waldron T, Chin J, et al. High-intensity focused ultrasound for prostate cancer: a systematic review. Clin Oncol (R Coll Radiol), 2011, 23(2): 117-127.
52. Bhardwaj N, Strickland AD, Ahmad F, et al. Liver ablation techniques: a review. Surg Endosc, 2010, 24(2): 254-265.
53. Pathak S, Jones R, Tang JM, et al. Ablative therapies for colorectal liver metastases: a systematic review. Colorectal Dis, 2011, 13(9): e252-265.
54. Garcea G, Lloyd TD, Aylott C, et al. The emergent role of focal liver ablation techniques in the treatment of primary and secondary liver tumours. Eur J Cancer, 2003, 39(15): 2150-2164.
55. Boutros C, Somasundar P, Garrean S, et al. Microwave coagulation therapy for hepatic tumors: review of the literature and critical analysis. Surg Oncol, 2010, 19(1): e22-32.
56. Shibata T, Niinobu T, Ogata N, et al. Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma. Cancer, 2000: 276-84.
57. Vente MA, Wondergem M, van der Tweel I, et al. Yttrium-90 microsphere radioembolization for the treatment of liver malignancies: a structured meta-analysis. Eur Radiol, 2009, 19(4): 951-959.
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Chinese Journal of Evidence-Based Medicine

Status Quo of Global Interventional Therapy for Tumors: A Systematic Review

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