The Efficacy of Transcatheter Arterial Chemoembolization Combined with Hepatic Arterial Infusion Chemotherapy in the Treatment of Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

doi:10.3877/cma.j.issn.2095-5782.2026.03.002

Abstract

Abstract:

Objective

To investigate the efficacy and safety of transcatheter arterial chemoembolization combined with hepatic arterial infusion chemotherapy in the treatment of unresectable hepatocellular carcinoma.

Methods

Search for articles published in PubMed, Embase, Web of Science, CNKI, Wanfang and VIP databases from January 1, 2015 to December 31, 2025 that discuss the treatment of unresectable hepatocellular carcinoma with TACE combined with HAIC. Extract relevant data such as objective response rate, disease control rate, overall survival, progression-free survival, and adverse events, and conduct a Meta-analysis using Review Manager 5.4 software.

Results

A total of 7 articles were included. The meta-analysis results showed that the TACE combined with HAIC group had better outcomes in terms of ORR、DCR、OS、PFS compared to the TACE group. For any grade adverse events, The risk of adverse reactions in the TACE combined with HAIC group was higher than that in the TACE group. For grade 3-4 adverse events, The risk of pain and elevated alanine aminotransferase in the TACE combined with HAIC group was higher than that in the TACE group.

Conclusion

Based on the current evidence, the combination of TACE and HAIC may improve the tumor response rate and prolong survival time, its safety remains to be investigated. However, further confirmation is required from prospective, multicenter, randomized controlled trials.

Key words: hepatocellular carcinoma, hepatic arterial infusion chemotherapy, transcatheter arterial chemoembolization, meta-analysis

Kun Liu, Li Li, Lu Huang, Mingzheng Hu. The Efficacy of Transcatheter Arterial Chemoembolization Combined with Hepatic Arterial Infusion Chemotherapy in the Treatment of Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2026, 14(03): 235-242.

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Figures/Tables 7

References 23

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第一作者	年份	分组	例数	年龄（岁，均数±标准差/分层例数）	男性/女性（例）	BCLC分期（A/B/C，例）	Child-Pugh（A/B，例）	AFP(ng/L，分层：≤阈值/>阈值，例)	治疗周期（次）	随访时间（月）	NOS评分（分）
靳成岳等^[5]	2024	TACE+HAIC	39	48.9±12.4	4/35	0/19/20	36/3	<400/>400 (19/20)	≤3/4~6(22/17)	18.30	7
靳成岳等^[5]	2024	TACE	39	54.3±12.2	3/36	0/16/23	36/3	<400/>400 (18/21)	≤3/4~6(25/14)	18.30	7
Gao等^[6]	2015	TACE+HAIC	45	57.2±10.3	41/4	3/15/21	41/4	-	共137	9.3	7
Gao等^[6]	2015	TACE	39	59.9±13.1	35/4	4/9/22	35/4	-	共92	9.3	7
Liu等^[7]	2025	TACE+HAIC	77	54.7±12.0	69/8	10/10/57	53/24	<400/>400(31/46)	3	18.30	8
Liu等^[7]	2025	TACE	77	55.9±12.2	70/7	10/19/58	57/20	<400/>400(27/50)	3	24.20	8
夏银锋等^[10]	2023	TACE+HAIC	80	53	65/15	6/35/39	75/5	<1000/>1000(48/32)	2.06	12	7
夏银锋等^[10]	2023	TACE	76	55.6	68/8	12/39/25	73/3	<1000/>1000(54/22)	2.29	12	7
Li等^[11]	2021	TACE+HAIC	41	≥60/<60(11/30)	30/11	-	-	≤20/>20(6/35)	-	19.60	8
Li等^[11]	2021	TACE	42	≥60/<60(17/25)	37/5	-	-	≤20/>20(13/39)	-	47.80	8
Liu等^[12]	2021	TACE+HAIC	60	54.7±9.5	53/7	-	56/4	<1000/>1000(26/34)		93.00	8
Liu等^[12]	2021	TACE	60	53.6±11.5	51/9	-	56/4	<1000/>1000(26/34)		57.00	8
Wu等^[13]	2022	TACE+HAIC	16	47.6	16/0	-	-	<400/>400(8/8)	-	治疗后第3个月复查	6
Wu等^[13]	2022	TACE	17	48.6	17/0	-	-	<400/>400(10/7)	-	治疗后第3个月复查	6

第一作者	年份	分组	例数	年龄（岁，均数±标准差/分层例数）	男性/女性（例）	BCLC分期（A/B/C，例）	Child-Pugh（A/B，例）	AFP(ng/L，分层：≤阈值/>阈值，例)	治疗周期（次）	随访时间（月）	NOS评分（分）
靳成岳等^[5]	2024	TACE+HAIC	39	48.9±12.4	4/35	0/19/20	36/3	<400/>400 (19/20)	≤3/4~6(22/17)	18.30	7
靳成岳等^[5]	2024	TACE	39	54.3±12.2	3/36	0/16/23	36/3	<400/>400 (18/21)	≤3/4~6(25/14)	18.30	7
Gao等^[6]	2015	TACE+HAIC	45	57.2±10.3	41/4	3/15/21	41/4	-	共137	9.3	7
Gao等^[6]	2015	TACE	39	59.9±13.1	35/4	4/9/22	35/4	-	共92	9.3	7
Liu等^[7]	2025	TACE+HAIC	77	54.7±12.0	69/8	10/10/57	53/24	<400/>400(31/46)	3	18.30	8
Liu等^[7]	2025	TACE	77	55.9±12.2	70/7	10/19/58	57/20	<400/>400(27/50)	3	24.20	8
夏银锋等^[10]	2023	TACE+HAIC	80	53	65/15	6/35/39	75/5	<1000/>1000(48/32)	2.06	12	7
夏银锋等^[10]	2023	TACE	76	55.6	68/8	12/39/25	73/3	<1000/>1000(54/22)	2.29	12	7
Li等^[11]	2021	TACE+HAIC	41	≥60/<60(11/30)	30/11	-	-	≤20/>20(6/35)	-	19.60	8
Li等^[11]	2021	TACE	42	≥60/<60(17/25)	37/5	-	-	≤20/>20(13/39)	-	47.80	8
Liu等^[12]	2021	TACE+HAIC	60	54.7±9.5	53/7	-	56/4	<1000/>1000(26/34)		93.00	8
Liu等^[12]	2021	TACE	60	53.6±11.5	51/9	-	56/4	<1000/>1000(26/34)		57.00	8
Wu等^[13]	2022	TACE+HAIC	16	47.6	16/0	-	-	<400/>400(8/8)	-	治疗后第3个月复查	6
Wu等^[13]	2022	TACE	17	48.6	17/0	-	-	<400/>400(10/7)	-	治疗后第3个月复查	6

文献	暴露组代表性（1分）	非暴露组代表性（1分）	暴露因素确定（1分）	开始前无要观察结局指标（1分）	最重要因素（1分）	其他因素（1分）	结局指标评价（1分）	随访时间（大于3个月，1分）	完整性（1分）	总得分（9分）
靳成岳等^[5]	1	1	1	1	1	0	1	1	0	7
Gao等^[6]	1	1	1	1	1	0	1	1	0	7
Liu等^[7]	1	1	1	1	1	1	1	1	0	8
夏银锋等^[10]	1	1	1	1	1	0	1	1	0	7
Li等^[11]	1	1	1	1	1	0	1	1	1	8
Liu等^[12]	1	1	1	1	1	0	1	1	1	8
Wu等^[13]	1	1	1	1	1	0	1	0	0	6

文献	暴露组代表性（1分）	非暴露组代表性（1分）	暴露因素确定（1分）	开始前无要观察结局指标（1分）	最重要因素（1分）	其他因素（1分）	结局指标评价（1分）	随访时间（大于3个月，1分）	完整性（1分）	总得分（9分）
靳成岳等^[5]	1	1	1	1	1	0	1	1	0	7
Gao等^[6]	1	1	1	1	1	0	1	1	0	7
Liu等^[7]	1	1	1	1	1	1	1	1	0	8
夏银锋等^[10]	1	1	1	1	1	0	1	1	0	7
Li等^[11]	1	1	1	1	1	0	1	1	1	8
Liu等^[12]	1	1	1	1	1	0	1	1	1	8
Wu等^[13]	1	1	1	1	1	0	1	0	0	6

不良反应	任何等级（发生数/总数）					3~4级（发生数/总数）
不良反应	研究数量	T+H	T	RR(95% CI）	P值	研究数量	T+H	T	RR(95% CI）	P值
腹痛	7	249/476	235/543	1.21(1.06~1.38)	<0.001	6	48/460	28/526	1.96(1.25~3.07)	<0.001
发热	6	192/344	221/433	1.09(0.96~1.25)	0.18	5	14/312	17/399	1.05(0.53~2.10)	0.88
恶心呕吐	7	194/476	127/543	1.74(1.45~2.10)	<0.001	6	23/460	19/526	1.47(0.81~2.67)	0.20
贫血	4	65/248	47/340	1.90(1.35~2.66)	<0.001	4	5/248	5/340	1.37(0.40~4.68)	0.61
中性粒细胞降低	7	99/476	55/543	2.05(1.51~2.79)	<0.001	6	15/460	9/526	1.90(0.84~4.30)	0.12
血小板降低	6	155/460	80/526	2.22(1.74~2.81)	<0.001	6	16/460	14/526	1.31(0.65~2.65)	0.46
胆红素升高	6	204/344	165/433	1.56(1.34~1.80)	<0.001	5	20/328	18/416	1.40(0.75~2.60)	0.29
谷丙转氨酶升高	7	301/476	274/543	1.25(1.12~1.40)	<0.001	6	47/460	32/526	1.68(1.09~2.58)	0.02
谷草转氨酶升高	6	281/435	250/501	1.29(1.16~1.46)	<0.001	5	12/419	12/484	1.16(0.52~2.54)	0.72

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