Efficacy of prophylactic dexamethasone in reducing post-embolization syndrome following transcatheter arterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis

Abstract Background and objectives Transcatheter arterial chemoembolization (TACE) is a fundamental treatment for unresectable hepatocellular carcinoma despite its tendency to induce postembolization syndrome (PES), which can negatively impact the quality of life and treatment outcomes of patients....

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Main Authors: Rongli Li, Zhen Huang, Yun Liu, Teng Li
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-04169-3
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author Rongli Li
Zhen Huang
Yun Liu
Teng Li
author_facet Rongli Li
Zhen Huang
Yun Liu
Teng Li
author_sort Rongli Li
collection DOAJ
description Abstract Background and objectives Transcatheter arterial chemoembolization (TACE) is a fundamental treatment for unresectable hepatocellular carcinoma despite its tendency to induce postembolization syndrome (PES), which can negatively impact the quality of life and treatment outcomes of patients. This study aimed to evaluate the efficacy of prophylactic dexamethasone in reducing PES following TACE. Methods A thorough search across major databases was conducted to identify studies investigating the prophylactic use of dexamethasone in preventing and reducing PES. Efficacy was evaluated via a meta-analysis utilizing a random-effects model to determine the risk ratio (RR) and 95% confidence intervals (CIs), focusing on PES symptoms, including abdominal pain, fever, nausea, and vomiting. Results Among 406 meticulously reviewed studies, 5, encompassing a patient cohort of 400 individuals, were included in the final analysis. The results revealed a significant reduction in the overall incidence of abdominal pain (RR = 0.61; 95% CI: 0.51–0.75; P < 0.001), fever (RR = 0.46; 95% CI: 0.35–0.60; P < 0.001), and nausea and vomiting (RR = 0.57; 95% CI: 0.43–0.76; P < 0.001) using dexamethasone prophylactically. Conclusion This meta-analysis suggested that the prophylactic administration of dexamethasone effectively prevents and reduces PES, significantly reducing the incidence of key symptoms, including abdominal pain, fever, nausea, and vomiting.
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issn 1471-230X
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publishDate 2025-08-01
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spelling doaj-art-276f65dc50f545c1a15ff7df53ee64922025-08-20T03:05:21ZengBMCBMC Gastroenterology1471-230X2025-08-0125111110.1186/s12876-025-04169-3Efficacy of prophylactic dexamethasone in reducing post-embolization syndrome following transcatheter arterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysisRongli Li0Zhen Huang1Yun Liu2Teng Li3Department of Interventional Radiology, The People‘s Hospital of WeifangDepartment of Interventional Radiology, The People‘s Hospital of WeifangDepartment of Hematology, The People‘s Hospital of WeifangDepartment of Interventional Radiology, The People‘s Hospital of WeifangAbstract Background and objectives Transcatheter arterial chemoembolization (TACE) is a fundamental treatment for unresectable hepatocellular carcinoma despite its tendency to induce postembolization syndrome (PES), which can negatively impact the quality of life and treatment outcomes of patients. This study aimed to evaluate the efficacy of prophylactic dexamethasone in reducing PES following TACE. Methods A thorough search across major databases was conducted to identify studies investigating the prophylactic use of dexamethasone in preventing and reducing PES. Efficacy was evaluated via a meta-analysis utilizing a random-effects model to determine the risk ratio (RR) and 95% confidence intervals (CIs), focusing on PES symptoms, including abdominal pain, fever, nausea, and vomiting. Results Among 406 meticulously reviewed studies, 5, encompassing a patient cohort of 400 individuals, were included in the final analysis. The results revealed a significant reduction in the overall incidence of abdominal pain (RR = 0.61; 95% CI: 0.51–0.75; P < 0.001), fever (RR = 0.46; 95% CI: 0.35–0.60; P < 0.001), and nausea and vomiting (RR = 0.57; 95% CI: 0.43–0.76; P < 0.001) using dexamethasone prophylactically. Conclusion This meta-analysis suggested that the prophylactic administration of dexamethasone effectively prevents and reduces PES, significantly reducing the incidence of key symptoms, including abdominal pain, fever, nausea, and vomiting.https://doi.org/10.1186/s12876-025-04169-3Transcatheter arterial chemoembolizationHepatocellular carcinomaPostembolization syndromeDexamethasoneMeta-analysis
spellingShingle Rongli Li
Zhen Huang
Yun Liu
Teng Li
Efficacy of prophylactic dexamethasone in reducing post-embolization syndrome following transcatheter arterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis
BMC Gastroenterology
Transcatheter arterial chemoembolization
Hepatocellular carcinoma
Postembolization syndrome
Dexamethasone
Meta-analysis
title Efficacy of prophylactic dexamethasone in reducing post-embolization syndrome following transcatheter arterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis
title_full Efficacy of prophylactic dexamethasone in reducing post-embolization syndrome following transcatheter arterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis
title_fullStr Efficacy of prophylactic dexamethasone in reducing post-embolization syndrome following transcatheter arterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis
title_full_unstemmed Efficacy of prophylactic dexamethasone in reducing post-embolization syndrome following transcatheter arterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis
title_short Efficacy of prophylactic dexamethasone in reducing post-embolization syndrome following transcatheter arterial chemoembolization for hepatocellular carcinoma: a systematic review and meta-analysis
title_sort efficacy of prophylactic dexamethasone in reducing post embolization syndrome following transcatheter arterial chemoembolization for hepatocellular carcinoma a systematic review and meta analysis
topic Transcatheter arterial chemoembolization
Hepatocellular carcinoma
Postembolization syndrome
Dexamethasone
Meta-analysis
url https://doi.org/10.1186/s12876-025-04169-3
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