To systematically review the difference between the efficacy of sodium alginate microspheres and traditional iodized oil transcatheter arterial chemoembolization in the treatment of primary liver cancer.

We searched databases including VIP, Wanfang, CNKI, CBM, PubMed, EMBASE, Cochrane Library and Web of science by means of coherent search of keywords and free words. The Meta-analysis was performed by using RevMan5.3 and Stata12.0 statistical software.

A total of 10 randomized controlled trials involving 710 patients were included. The results of meta-analysis indicated that the 6-month survival rate [OR = 1.98, 95%CI = (1.20, 3.25), P = 0.007], the 9-month survival rate [OR = 1.94, 95%CI = (1.05, 3.56) ), P = 0.03] and the 12-month survival rate [OR = 2.62, 95%CI = (1.83, 3.75), P < 0.000 01] in the sodium alginate microsphere group were significantly higher than those in the iodized oil group. The degree of tumor reduction after treatment [OR = -6.22, 95%CI (-6.83, -5.61), P < 0.000 01], and the degree of decrease in alpha-fetoprote in the sodium alginate microsphere group were significantly higher than those in the traditional iodized oil group [MD = -361.18, 95%CI (-576.26, -146.09), P = 0.001].The disease progression rate was significantly lower than that of the iodized oil group [OR = 0.28, 95%CI (0.15, 0.52), P < 0.000 1], while there were no significant differences between the two groups in the tumor complete remission rate [OR = 1.56, 95%CI (0.54, 4.51), P = 0.41] and partial remission rate [OR = 1.82, 95%CI (1.01, 3.29), P = 0.05]. There were no significant differences between the two groups in the incidence of fever [OR = 1.38, 95%CI = (0.82, 2.31), P = 0.22], nausea and vomiting [OR = 0.74, 95%CI = (0.46, 1.20), P = 0.22], and abdominal pain [OR = 1.28, 95%CI = (0.87, 1.87), P = 0.21]. Sensitivity analysis of the results was carried out by one-by-one elimination method, and no significant changes were found in the results, suggesting that the overall results of this meta-analysis were stable. The Begg's funnel plot did not indicate evidence of publication bias (P = 0.232 > 0.1).

The current evidence shows that compared with traditional iodized oil transcatheter arterial chemoembolization, sodium alginate microsphere transcatheter arterial chemoembolization is a safe clinical treatment and can significantly improve the survival rate of patients with primary liver cancer.