Page 202 - Read Online

Zhao et al. Hepatoma Res 2019;5:17 I http://dx.doi.org/10.20517/2394-5079.2018.116 Page 3 of 10

Figure 1. The earch and selection of eligible clinical studies. CNKI: Chinese Knowledge resources integrated; VIP: Chinese Scientific
Journal Full-Text Database; CBM: China Biology Medicine

with TACE, while a control group passed TACE or SBRT merely; (3) HCC should be diagnosed by computed
tomography (CT), magnetic resonance imaging or pathology; (4) the research results should include the
total effective rate at least. The overall effective rate = (CR + PR)/the total participants × 100%, CR: tumor
completely subsided and no re-occurrence of new tumors for at least four weeks; PR: tumor size shrunk
more than 50% and no re-occurrence of new tumors for at least four weeks.

Publications complied with the following criteria were excluded: (1) the repetitive studies and unsuitable
publication types, narrative reviews, systematic reviews, letters, comments, case reports or studies unrelated
to our topics; (2) the studies including patients with metastatic liver cancer, under other therapies or three
intervention procedures; (3) the studies including patients with severe cirrhosis, massive ascites or severe
hepatic insufficiency; (4) the data were unable to be extracted from the reviews; (5) no control group was
established in the reviews; (6) the studies including patients who had metastatic or recurrent liver carcinoma.

Identification of eligible studies
After searching the literature within several databases, 399 potentially relevant studies were identified initially.
After the examination of titles and abstracts, 156 surveys were excluded and 57 articles were selected for full-
text screening. Finally, 13 studies were included for this meta-analysis. The study recruitment flowchart was
shown in [Figure 1].

Data extraction of the studies
All included studies were published from 2008 to 2017. A total of 1,209 patients were enrolled, including 625
patients from the observation group and 584 patients from the control group. Among the patients, the male
was 862 and female was 347. All patients were followed up for at least one year. Also, KPS score, Child-pugh
score and TNM stage of the patients were also described. The data of the baseline characteristics of the
patients in the included studies are presented in Table 1.

Study quality assessment
Two researchers (Shoujie Zhao and Baishu Dai) independently evaluated the included studies. The authors’
name and institution were blinded to researchers. The risk of bias in RCTs was assessed according to the
Cochrane Risk of Bias tool which is based on the following aspects: random sequence generation, allocation
[12]
concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome
data, and selective reporting. All the disagreements were discussed with the third researchers (Yong Long)
to reach consensus.