{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T14:27:13Z","timestamp":1793802433643,"version":"4.6.1"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal integration of locoregional therapies for unresectable hepatocellular carcinoma (HCC) remains an area of active investigation. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of combining transcatheter arterial chemoembolization (TACE) with stereotactic body radiotherapy (SBRT) compared to TACE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A comprehensive literature search was conducted across five databases up to March 1, 2026. Eligible studies compared TACE combined with SBRT versus TACE (with or without concurrent systemic therapy) for unresectable HCC. The primary outcomes were overall survival (OS) and progression-free survival (PFS), with treatment-related adverse events (CTCAE grade \u22653) as a key safety outcome. Pooled hazard ratios (HR) and risk ratios (RR) with 95% confidence intervals (CI) were calculated using random-effects models. Heterogeneity was assessed using Cochran\u2019s Q test and the\n                      <jats:italic>I\u00b2<\/jats:italic>\n                      statistic. Subgroup analyses (by study design, concurrent systemic therapy, and HR adjustment) and sensitivity analyses were performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies involving 828 patients were included. The TACE-SBRT combination significantly improved OS (HR\u00a0=\u00a00.48, 95% CI: 0.35\u20130.65,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001; I\u00b2 = 13%) and PFS (HR\u00a0=\u00a00.45, 95% CI: 0.32\u20130.65,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001; I\u00b2 = 54%) compared to TACE. There was no statistically significant difference in the incidence of grade \u22653 adverse events between the two groups (RR\u00a0=\u00a01.27, 95% CI: 0.87\u20131.86,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.21). Sensitivity analyses confirmed the robustness of the findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with unresectable HCC, the combination of TACE and SBRT appears to confer a survival advantage over TACE, without significantly increasing the risk of severe adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261350374<\/jats:ext-link>\n                      , identifier CRD 420261350374.\n                    <\/jats:p>\n                  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