SynthesisFrontiers in medicine2026
Comparative efficacy and safety of transarterial treatment strategies for hepatocellular carcinoma: a systematic review and network meta-analysis of randomized controlled trials.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Transarterial therapy is widely used for unresectable or intermediate-stage hepatocellular carcinoma (HCC), but the comparative efficacy and safety of available techniques remain uncertain. We compared the efficacy and safety of conventional TACE (cTACE), drug-eluting bead TACE (DEB-TACE), degradable starch microsphere TACE (DSM-TACE), balloon-occluded TACE (B-TACE), transarterial embolization (TAE), and transarterial radioembolization (TARE). Methods: We performed a PROSPERO-registered systematic review and network meta-analysis of randomized controlled trials. PubMed, Embase, Web of Science, CENTRAL, and CNKI were searched from inception to May 1, 2026. The primary efficacy outcome was objective response rate (ORR). Random-effects network meta-analysis was used. Risk of bias was assessed with RoB 2, and certainty of evidence with CINeMA. Results: Fifty-six randomized trials involving 5,083 patients were included; 48 trials (4,282 patients) contributed to the ORR network. B-TACE yielded an ORR risk ratio (RR) of 3.50 versus cTACE (95% CI 1.92-6.36, Conclusion: Among currently available randomized evidence, DEB-TACE showed the most consistent overall benefit compared with cTACE, improving tumor response while reducing common post-embolization symptoms. The apparently large B-TACE ORR effect should be considered hypothesis-generating because it is based on sparse, clinically indirect evidence. Comparisons of DSM-TACE, B-TACE, TAE, and TARE with cTACE remain insufficient to establish a definitive overall advantage. Systematic review registration: PROSPERO registration: CRD420261392214.
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