Traditional Chinese medicine plus transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma.

Objectives: To compare the efficacy and safety of Traditional Chinese Medicine (TCM) plus transcatheter arterial chemoembolization (TACE) with that of TACE alone (therapy I versus therapy II, respectively) in treating unresectable hepatocellular carcinoma (UHCC) through a meta-analysis of all available randomized controlled trials. Methods: Literature retrieval was conducted using the Cochrane Library, MEDLINE (R), EMBASE, CBMdisk, and CNKI in any language. Meta-analysis was performed on the results of homogeneous studies. Analyses subdivided by TACE frequency (subgroup A, < 3 times; subgroup B, >= 3 times) were also performed, but were not done for both therapy I and therapy II. Results: Based on our search criteria, we found 37 trials involving 2653 patients. Our results showed that therapy I, compared with therapy II, improved patient survival, quality of life, alleviation of symptoms, and tumor response, and was thus more therapeutically beneficial. Further analysis showed that subgroup A proved to be better for patients' survival and alleviation of symptoms, while the two subgroups were similar in improved tumor response. No serious adverse events were reported. Conclusions: Therapy I benefited patients with UHCC. Subgroup A improved the survival of patients and the amelioration of symptoms more than subgroup B. As in some trials, there were flaws in the methodological quality, and the data therefore have a risk of bias and of being insufficient for determining the effects of therapy I and subgroup A. Hence, further large-scale trials are warranted.