Objective:To conduct a Meta-analysis comparing the efficacy and safety of external beam radiation therapy(EBRT)combined with tyrosine kinase inhibitors(TKI)versus EBRT or TKI monotherapy in the treatment of non-resectable live cancer.Methods:Literature were searched in PubMed,Web of Science,Embase,and the Cochrane Library,CNKI,WanFang Data,Vip,and SinoMed until April 1st,2023.Statistical analyses were conducted using RevMan 5.4 software.Results:Twelve studies with a total of 922 patients were included.The results showed:(1)Effectiveness:the objective remission rate(ORR)and disease control rate(DCR)of the combination therapy group were higher than those of the monotherapy group(OR =2.33,95%CI 1.55-3.52,P＜0.001;OR =5.09,95%CI 2.78-9.32,P<0.001).The overall survival(OS),disease-free survival(DFS),and progression-free survival(PFS)in the combination therapy group were significantly higher than those in the monotherapy group(HR = 0.67,95%CI 0.57-0.79,P<0.001;HR = 0.58,95%CI 0.48～0.70,P<0.001).(2)safety:no significant difference was observed in the total number of adverse events(AEs)between the two groups(OR =1.11,95%CI 0.93-1.31,P =0.25).However,the incidence of grade 3 or higher AEs was higher in the combination therapy group(OR =1.94,95%CI 1.11-3.38,P =0.02).Analysis of different classifications of AEs without limits revealed that,except for gastric discomfort/abdominal pain,skin reactions,and leukopenia,no significant difference was found between the two groups for other AEs(P＞0.05).(3)Subgroup analysis:no significant difference was observed between the two groups in terms of grade≥3 AEs in the presence of distant metastasis and the control group when the intervention was TKI.Additionally,no significant difference was found between the two groups for ORR,DCR in the absence of distant metastasis,and the remaining results were consistent with the overall population analysis results.Conclusion:EBRT combined with TKI can significantly improve the prognosis of patients with non-resectable hepatocellular carcinoma compared with monotherapy,and the overall adverse events are controllable.However,we should be alert to the occurrence of grade≥3 AEs,which needs to be further verified by a large-sample,high-quality randomized controlled trial.
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