Efficacy of Transarterial Chemoembolization Combined with Tyrosine Kinase Inhibitors for Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus: A Systematic Review and Meta-Analysis

Round 1

Reviewer 1 Report

• The full search strategies for all databases, registers, and websites should be presented, including any filters and limits used. • All outcomes for which data were sought should be listed and defined. Whether all results that were compatible with each outcome domain in each study were sought (e.g. for all measures, time points, analyses) should be specified. * How were subgroup and sensitivity analyses performed when heterogeneity was observed? Please give detailed information. • The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) can be proposed for this meta-analysis study.

* Why was the modified Jadad scale used for Quality Assessment of RCT?

Author Response

Please find the Response letter in the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

In this manuscript, the author has a systematic review and meta-analysis for the efficacy of Transartherial Chemoembolization (TACE) combined with Tyrosine Kinase Inhibitors (TKIs) in the treatment of hepatocellular carcinoma portal with vein tumor thrombosis through literature retrieval of all major databases in recent years, and meta-analysed the efficacy of various TKI drugs combined with TACE through literature retrieval. However, there are still some doubts about the elaboration and discussion results in this review, which hinder our understanding of this article. Therefore, the reviewer hopes that the author will carefully revise the article and give a reasonable explanation to the questions raised. The review comments are as follows:

1.    In the "Abstract" of the manuscript, the "detabase" needs to be changed to "detabases" in "Methods".

2.    In the "Introduction" section of the manuscript, the author's introduction to the anti-cancer mechanism of TACE combined with TKIs in the treatment of liver cancer is too simple, please introduce in detail. Some related references of 10.1021/acsami.2c11423, 10.1016/j.cej.2022.135963, 10.1016/j.cej.2019.123619 are needed. In the literature searched, please briefly introduce whether there are other drugs other than tyrosine kinase inhibitors that can be used for combined treatment of liver cancer.

3.    In chapter 2.1 of the manuscript, the author proposes that "studies had adult patients......", and whether the author needs to consider adult patients with other disease bases or young patients.

4.    When studying the effects of different types of PVTT, in order to make readers better understand, whether the author needs to put the third part of Chapter 3.2 and Chapter 2.3.4 together.

5.    In Chapter 2.3.4 of the manuscript, the author proposed that "Type I and type II PVTT had prolonged overall survival and disease progression.", the introduction is confusing. Please introduce the therapeutic effect of TACE combined with different TKIs on Type I and Type II PVTT in detail.

 

Author Response

Please find Response letter in the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Revisions are enough