Abstract P111: Comparative Efficacy Of Bisoprolol Compared To Other Selective Beta-1 Blockers In Patients With Hypertension - A Systematic Review And Meta-analysis Of Observational Studies

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Uday M Jadhav ◽  
Tiny Nair ◽  
SANDEEP BANSAL ◽  
Saumitra Ray
Keyword(s):  
Lipid Profile ◽  
Observational Studies ◽  
Clinical Decision Making ◽  
Meta Analysis ◽  
Hdl Cholesterol ◽  
Clinical Decision ◽  
Cochrane Library ◽  
Favourable Effect ◽  
Pooled Data ◽  
Cholesterol Levels

Introduction: Selective beta-1 blockers (s-BBs) are used in the management of hypertension (HT) in specific subsets. Studies comparing the potency of blood pressure (BP) lowering with different s-BBs are sparse. The objective of this meta-analysis was to evaluate the efficacy of bisoprolol compared to other s-BBs (Atenolol, Betaxolol, Esmolol, Acebutolol, Metoprolol, Nebivolol) in HT patients by examining their effect on BP, heart rate (HR) and metabolic derangements, by examining the evidences reported in observational studies. Methods: Electronic databases like PubMed, EMBASE, Cochrane Library, Clinicaltrials.gov, Surveillance, Epidemiology and End Results Program and 12 PV databases were systematically searched from inception to October 2019. Observational studies that compared bisoprolol with other s-BBs in patients with HT were evaluated in accordance with the PRISMA guidelines. Pooled data were calculated using random-effects model for meta-analysis in terms of mean difference (MD) and 95% confidence interval (95% CI) for each outcome. Outcomes of interest were BP, HR and lipid profile. Results: Four observational studies which compared bisoprolol with other s-BBs (nebivolol and atenolol) were included in this meta-analysis. Significant reduction was observed in office diastolic BP [MD: -1.70; 95% CI: -2.68,-0.72; P <0.01] among arterial HT patients treated with bisoprolol for 26 weeks (w) compared to those treated with other s-BBs. HT patients treated with bisoprolol for 26 w showed significant reduction in HR [MD: -2.20; 95% CI: -3.57,-0.65; P <0.01] and office HR [MD: -2.55; 95% CI: -3.57,-1.53; P <0.01] than other s-BBs. HDL cholesterol levels increased significantly in essential HT patients treated with bisoprolol at 26 w [MD: 7.17; 95% CI: 1.90,12.45; P <0.01], 78 w [MD: 11.70; 95% CI: 4.49,18.91; P <0.01] and 104 w [MD: 10.20, 95% CI: 4.49,18.91; P <0.01] compared to other s-BBs. Conclusion: Our results suggests that bisoprolol is superior to other s-BBs in reducing BP and HR. Bisoprolol also had a favourable effect on lipid profile shown by increase in HDL cholesterol. This meta-analysis emphasizes the efficacy of bisoprolol over other s-BBs, which aids clinical decision making in treatment of patients with HT.

scholarly journals The short- to midterm effectiveness of stemless prostheses compared to stemmed prostheses for patients who underwent total shoulder arthroplasty: a meta-analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Wei Peng ◽  
Yufu Ou ◽  
Chenglong Wang ◽  
Jianxun Wei ◽  
Xiaoping Mu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
Clinical Decision Making ◽  
Constant Score ◽  
Data Extraction ◽  
Meta Analysis ◽  
Total Shoulder Arthroplasty ◽  
Clinical Decision ◽  
Clinical Results ◽  
Cochrane Library

Abstract Background To systematically compare the short- to midterm effectiveness of stemless prostheses to that of stemmed prostheses for patients who underwent total shoulder arthroplasty (TSA) and to provide a guideline for clinical decision-making. Methods PubMed, the Cochrane Library, and Web of Science were searched with the given search terms until July 2019 to identify published articles evaluating the clinical outcomes for stemless prostheses compared with stemmed prostheses for patients who underwent TSA. Data extraction and the quality assessment of the included studies were independently performed by two authors. Stata software 14.0 was used to analyze and synthesize the data. Results Two randomized controlled trials and six case-controlled studies with a total of 347 shoulders were included in this meta-analysis. The results of this meta-analysis showed that there were no significant differences between the stemless and stemmed prostheses in terms of the Constant score, pain score, strength, activities of daily living, postoperative range of motion (ROM), and postoperative maximum active ROM. Conclusions This is the first meta-analysis reporting the clinical results of stemless TSA in the short- to midterm follow-up period. Both types of shoulder prostheses were similar in achieving satisfactory clinical outcomes.

scholarly journals Effects of Soy Protein Containing of Isoflavones and Isoflavones Extract on Plasma Lipid Profile in Postmenopausal Women as a Potential Prevention Factor in Cardiovascular Diseases: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2531
Author(s):  
Agnieszka Barańska ◽  
Agata Błaszczuk ◽  
Wiesław Kanadys ◽  
Bożena Baczewska ◽  
Marian Jędrych ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Postmenopausal Women ◽  
Soy Protein ◽  
Meta Analysis ◽  
Plasma Lipid ◽  
Hdl Cholesterol ◽  
Cochrane Library ◽  
Isolated Soy Protein ◽  
Milk Casein ◽  
The Impact

The aim of the report was to evaluate the impact of soy protein containing isoflavones and soy isoflavones extract on lipid profile in postmenopausal women, as compared with placebo or protein of milk, casein or isolated soy protein with or without trace isoflavone content. We used the following databases: MEDLINE (PubMed), EMBASE and the Cochrane Library. Quantitative data synthesis was performed by applying a random-effects model. Subgroup analysis and meta-regression were performed to assess the modifiers of treatment response. In total, in the analysis studies, 2305 postmenopausal women took part. Changes in the lipid profile showed statistically significant decreases of total cholesterol by −0.12 (95% CI: −0.21, −0.03) mmol/L, −4.64 (95% CI: −8.12, −1.16) mg/dL, p = 0.01 and increased HDL-cholesterol by 0.03 (95% CI: 0.00, 0.06) mmol/L, 1.15 (95% CI: 0.00, 1.93) mg/dL, p = 0.05, as well as in LDL-cholesterol −0.05 (95% CI: −0.11, 0.01) mmol/L, −1.93 (95% CI: −4.25, 0.39) mg/dL, p = 0.08 and triacylglycerols −0.07 (95% CI: −0.14, 0.00) mmol/L, −6.123 (95% CI: −12.25, 0.00) mg/dL, p = 0.06. Our results suggests that soy and its isoflavones can be effective in correction changes in lipid metabolism in postmenopausal women and may favorably influence in preventing cardiovascular events.

scholarly journals Serum lipid profile in HCV patients treated with direct-acting antivirals: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rosanna Villani ◽  
Francesca Di Cosimo ◽  
Antonino Davide Romano ◽  
Moris Sangineto ◽  
Gaetano Serviddio
Keyword(s):  
Systematic Review ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Meta Analysis ◽  
Antiviral Treatment ◽  
Hdl Cholesterol ◽  
Treatment Completion ◽  
Direct Acting Antivirals ◽  
Pooled Data ◽  
Direct Acting

AbstractAlthough direct-acting antivirals are very effective and safe drugs, several authors have reported the alteration of lipid profile during and after anti-HCV therapy suggesting a potential impact on the risk of cardiovascular events. We performed a systematic review and meta-analysis of observational studies to investigate the magnitude and temporal trend of lipid profile changes in DAA treated patients. All selected studies included data on lipid profile before starting therapy and at least one follow-up assessment during or after antiviral treatment. We identified 14 studies (N = 1537 patients) after removing duplicates. Pooled data showed an increase in total cholesterol 4 weeks after starting therapy (+ 15.86 mg/dl; 95% CI + 9.68 to 22.05; p < 0.001) and 12 weeks after treatment completion (+ 17.05 mg/dl; 95% CI + 11.24 to 22.85; p < 0.001). LDL trend was similar to the total cholesterol change in overall analysis. A mean increase in HDL-cholesterol of 3.36 mg/dl (95% CI + 0.92 to 5.79; p = 0.07) was observed after 12 weeks of treatment, whereas at SVR24 HDL difference was + 4.34 mg/dl (95% CI + 1.40 to 7.28; p = 0.004).Triglycerides did not show significant changes during treatment and after treatment completion. DAAs induce mild lipid changes in chronic hepatitis C patients treated with DAAs, which may persist after treatment completion.

scholarly journals Effect of Acupuncture on Cognitive Function of Insomnia Patients Compared with Drugs: A Protocol for Meta-analysis and Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Shan Qin ◽  
Jing Jiang ◽  
Wen-Zhong Wu ◽  
Xiao-Qiu Wang ◽  
Han-Qing Xi ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Clinical Decision Making ◽  
Data Extraction ◽  
Meta Analysis ◽  
Clinical Decision ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Statistical Process ◽  
Assessment Development ◽  
Third Person

Insomnia, one of the most common sleep disorders, is thought to have an adverse effect on cognitive function. At the same time, people with cognitive dysfunction are more prone to insomnia. At present, pharmacotherapy is the main treatment for insomnia, but there are some shortcomings such as poor long-term efficacy and potential dependence. There is some evidence that acupuncture has some advantages in alleviating insomnia and improving cognitive function. This study is aimed at investigating the effects of acupuncture and drugs on cognitive function in patients with insomnia and evaluating the efficacy and safety of these two interventions, providing strong evidence for clinical decision-making. The study will retrieve eight major databases: China National Knowledge Infrastructure, Wanfang Database, VIP Database for Chinese Technical Periodicals, SinoMed, PubMed, Web of Science, Embase, and Cochrane Library. Dissertations, conference papers, and ongoing experiments will also be retrieved for supplement. Literature screening and data extraction will be completed by two authors independently (JJ and X-QW). If there were any disagreements, they would be discussed or referred to a third person for adjudication (W-ZW). Authors will use Cochrane risk of bias tool to assess the included studies. The Review Manager Statistical (RevMan) software is used to conduct the statistical process of meta-analysis, and funnel plot is used to evaluate reporting biases. The Grading of Recommendations Assessment Development and Evaluation (GRADE) Profiler can be used to be aware of the quality of evidence.

Quercetin Actions on Lipid Profiles in Overweight and Obese Individuals: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 25 (28) ◽  
pp. 3087-3095 ◽  
Author(s):  
Wenfang Guo ◽  
Xue Gong ◽  
Minhui Li
Keyword(s):  
Total Dose ◽  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Meta Analysis ◽  
Plasma Lipid ◽  
Hdl Cholesterol ◽  
Cochrane Library ◽  
Control Group ◽  
Lipid Levels ◽  
Cholesterol Levels

Background: The lipid profile is associated with metabolic diseases in overweight and obese individuals. Quercetin treatment is suggested to reduce the risk factors for obesity. Objective: The aim of the literature meta-analysis was to determine the range of doses of quercetin administration on plasma lipid levels in overweight and obese human subjects. Methods: Articles searched on EMBASE, PubMed, Cochrane Library, and Web of Science through March 20, 2019, were reviewed independently using predetermined selection criteria. The Cochrane collaboration’s tool for assessing risk of bias was used to assess the quality of the included trials. Heterogeneity was measured using Cochran's Q test and the I-square (I2) statistic. Data were pooled using a random-effects model and the standardized mean difference (SMD) was considered for measuring the overall effect size. Results: Of 176 articles reviewed, 9 randomized clinical trials were selected based on the inclusion criteria. The pooled results for the effect of quercetin administration on LDL-cholesterol (SMD: -002; 95% CI: -0.15–0.11), HDL-cholesterol (SMD: -0.06; 95% CI: -0.19–0.07), triglycerides (SMD: 0.05; 95% CI: -0.08–0.18), and total cholesterol (SMD: 0.04; 95% CI: -0.09–0.17) were not significantly different from the control group results. Quercetin administration at doses of ≥250 mg/day (SMD: -0.58 ; 95% CI: -0.94–-0.22) and total dose ≥14,000 mg (SMD: -0.58 ; 95% CI: -0.94–-0.22) significantly reduced LDL levels; however, HDL-cholesterol, triglycerides, and total cholesterol levels remained unchanged (p > 0.05). Conclusion: Quercetin administration does not affect plasma lipid levels in overweight and obese individuals. However, it significantly reduces LDL-cholesterol levels at doses of ≥250 mg/day and total dose ≥14000 mg.

scholarly journals The Efficacy of Iodine-131-Metaiodobenzylguanidine Therapy in Relapsed or Refractory Neuroblastoma: A Meta-Analysis

2021 ◽  
Author(s):  
Huihui He ◽  
Qiaoling Xu ◽  
Chunjing Yu
Keyword(s):  
Clinical Trials ◽  
Clinical Decision Making ◽  
Meta Analysis ◽  
Objective Response ◽  
Clinical Decision ◽  
Cochrane Library ◽  
Randomized Controlled Clinical Trials ◽  
Iodine 131 ◽  
Multiple Treatments ◽  
The Cochrane Library

Abstract ObjectiveNeuroblastoma is a common extracranial solid tumor of childhood. Recently, multiple treatments have been practiced including Iodine-131-metaiodobenzylguanidine radiation (131I-MIBG) therapy. However, the efficacy varies greatly. The aim of this meta-analysis is to evaluate the efficacy of 131I-MIBG for relapsed or refractory neuroblastoma and to provide evidence and hints for clinical decision-making.MethodsMedline, EMBASE database and the Cochrane Library were searched for relevant studies. Eligible studies were clinical trials of refractory assigned to 131I-MIBG with data on efficacy including tumor response. The overall efficacy was calculated using a random-effects model considering of the heterogeneity.ResultsA total of 26 clinical trials including 883 patients were analyzed. The overall rates of objective response SD, PD and MR was 39% (95% CI: 32%-47%), 31% (95% CI: 24%, 37%), 22% (95% CI: 15%, 30%) and 15% (95% CI: 3%, 31%), respectively. Overall objective response rates of 131I-MIBG in combination with chemotherapy was 28%（95% CI: 14%, 44%）. Median event-free survival (EFS) ranged from 10 to 16 months in the studies included.Conclusion131I-MIBG treatment is effective on clinical outcomes in relapsed or refractory neuroblastoma, more randomized-controlled clinical trials investigating the efficacy of 131I-MIBG in combination with chemotherapy should be conducted.

The Effects of L-Carnitine Supplementation on Serum Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 25 (30) ◽  
pp. 3266-3281 ◽  
Author(s):  
Hadis Fathizadeh ◽  
Alireza Milajerdi ◽  
Željko Reiner ◽  
Fariba Kolahdooz ◽  
Maryam Chamani ◽  
...  
Keyword(s):  
Serum Lipids ◽  
Ldl Cholesterol ◽  
Meta Analysis ◽  
Hdl Cholesterol ◽  
Health Conditions ◽  
Carnitine Supplementation ◽  
Randomized Controlled ◽  
Cholesterol Levels ◽  
Vldl Cholesterol ◽  
Subgroup Analyses

Background: The findings of trials investigating the effects of L-carnitine administration on serum lipids are inconsistent. This meta-analysis of randomized controlled trials (RCTs) was performed to summarize the effects of L-carnitine intake on serum lipids in patients and healthy individuals. Methods: Two authors independently searched electronic databases including MEDLINE, EMBASE, Cochrane Library, Web of Science, PubMed and Google Scholar from 1990 until August 1, 2019, in order to find relevant RCTs. The quality of selected RCTs was evaluated using the Cochrane Collaboration risk of bias tool. Cochrane’s Q test and I-square (I2) statistic were used to determine the heterogeneity across included trials. Weight mean difference (SMD) and 95% CI between the two intervention groups were used to determine pooled effect sizes. Subgroup analyses were performed to evaluate the source of heterogeneity based on suspected variables such as, participant’s health conditions, age, dosage of L-carnitine, duration of study, sample size, and study location between primary RCTs. Results: Out of 3460 potential papers selected based on keywords search, 67 studies met the inclusion criteria and were eligible for the meta-analysis. The pooled results indicated that L-carnitine administration led to a significant decrease in triglycerides (WMD: -10.35; 95% CI: -16.43, -4.27), total cholesterol (WMD: -9.47; 95% CI: - 13.23, -5.70) and LDL-cholesterol (LDL-C) concentrations (WMD: -6.25; 95% CI: -9.30, -3.21), and a significant increase in HDL-cholesterol (HDL-C) levels (WMD: 1.39; 95% CI: 0.21, 2.57). L-carnitine supplementation did not influence VLDL-cholesterol concentrations. When we stratified studies for the predefined factors such as dosage, and age, no significant effects of the intervention on triglycerides, LDL-C, and HDL-C levels were found. Conclusion: This meta-analysis demonstrated that L-carnitine administration significantly reduced triglycerides, total cholesterol and LDL-cholesterol levels, and significantly increased HDL-cholesterol levels in the pooled analyses, but did not affect VLDL-cholesterol levels; however, these findings were not confirmed in our subgroup analyses by participant’s health conditions, age, dosage of L-carnitine, duration of study, sample size, and study location.

scholarly journals The effects of clinical decision support system for prescribing medication on patient outcomes and physician practice performance: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sharare Taheri Moghadam ◽  
Farahnaz Sadoughi ◽  
Farnia Velayati ◽  
Seyed Jafar Ehsanzadeh ◽  
Shayan Poursharif
Keyword(s):  
Systematic Review ◽  
Decision Support ◽  
Patient Outcomes ◽  
Clinical Decision Support ◽  
Meta Analysis ◽  
Clinical Decision ◽  
Cochrane Library ◽  
Physician Practice ◽  
Positive Effects ◽  
Practice Performance

Abstract Background Clinical Decision Support Systems (CDSSs) for Prescribing are one of the innovations designed to improve physician practice performance and patient outcomes by reducing prescription errors. This study was therefore conducted to examine the effects of various CDSSs on physician practice performance and patient outcomes. Methods This systematic review was carried out by searching PubMed, Embase, Web of Science, Scopus, and Cochrane Library from 2005 to 2019. The studies were independently reviewed by two researchers. Any discrepancies in the eligibility of the studies between the two researchers were then resolved by consulting the third researcher. In the next step, we performed a meta-analysis based on medication subgroups, CDSS-type subgroups, and outcome categories. Also, we provided the narrative style of the findings. In the meantime, we used a random-effects model to estimate the effects of CDSS on patient outcomes and physician practice performance with a 95% confidence interval. Q statistics and I2 were then used to calculate heterogeneity. Results On the basis of the inclusion criteria, 45 studies were qualified for analysis in this study. CDSS for prescription drugs/COPE has been used for various diseases such as cardiovascular diseases, hypertension, diabetes, gastrointestinal and respiratory diseases, AIDS, appendicitis, kidney disease, malaria, high blood potassium, and mental diseases. In the meantime, other cases such as concurrent prescribing of multiple medications for patients and their effects on the above-mentioned results have been analyzed. The study shows that in some cases the use of CDSS has beneficial effects on patient outcomes and physician practice performance (std diff in means = 0.084, 95% CI 0.067 to 0.102). It was also statistically significant for outcome categories such as those demonstrating better results for physician practice performance and patient outcomes or both. However, there was no significant difference between some other cases and traditional approaches. We assume that this may be due to the disease type, the quantity, and the type of CDSS criteria that affected the comparison. Overall, the results of this study show positive effects on performance for all forms of CDSSs. Conclusions Our results indicate that the positive effects of the CDSS can be due to factors such as user-friendliness, compliance with clinical guidelines, patient and physician cooperation, integration of electronic health records, CDSS, and pharmaceutical systems, consideration of the views of physicians in assessing the importance of CDSS alerts, and the real-time alerts in the prescription.

scholarly journals Prognostic Value of Serum Magnesium in Mortality Risk among Patients on Hemodialysis: A Meta-Analysis of Observational Studies

2020 ◽  
pp. 1-10
Author(s):  
Hongwei Wu ◽  
Qiang Li ◽  
Lijing Fan ◽  
Dewang Zeng ◽  
Xianggeng Chi ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Cardiovascular Mortality ◽  
Observational Studies ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Serum Magnesium ◽  
Cochrane Library ◽  
Lower Serum ◽  
All Cause Mortality ◽  
End Stage

<b><i>Background:</i></b> Previous studies have reported that serum magnesium (Mg) deficiency is involved in the development of heart failure, particularly in patients with end-stage kidney disease. The association between serum Mg levels and mortality risk in patients receiving hemodialysis is controversial. We aimed to estimate the prognostic value of serum Mg concentration on all-cause mortality and cardiovascular mortality in patients receiving hemodialysis. <b><i>Methods:</i></b> We did a systematic literature search in PubMed, EMBASE, Cochrane Library, and Web of Science to identify eligible studies that reported the prognostic value of serum Mg levels in mortality risk among patients on hemodialysis. We performed a meta-analysis by pooling and analyzing hazard ratios (HRs) and 95% confidence intervals (CIs). <b><i>Results:</i></b> We identified 13 observational studies with an overall sample of 42,967 hemodialysis patients. Higher all-cause mortality (adjusted HR 1.58 [95% CI: 1.31–1.91]) and higher cardiovascular mortality (adjusted HR 3.08 [95% CI: 1.27–7.50]) were found in patients with lower serum Mg levels after multivariable adjustment. There was marked heterogeneity (<i>I</i><sup>2</sup> = 79.6%, <i>p</i> &#x3c; 0.001) that was partly explained by differences in age stratification and study area. In addition, subgroup analysis showed that a serum Mg concentration of ≤1.1 mmol/L might be the vigilant cutoff value. <b><i>Conclusion:</i></b> A lower serum Mg level was associated with higher all-cause mortality and cardiovascular mortality in patients receiving hemodialysis.

scholarly journals Therapeutic outcome and related predictors of stereotactic body radiotherapy for small liver-confined HCC: a systematic review and meta-analysis of observational studies

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yanyan Long ◽  
Yan Liang ◽  
Shujie Li ◽  
Jing Guo ◽  
Ying Wang ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Radiation Dose ◽  
Tumor Size ◽  
Stereotactic Body Radiotherapy ◽  
Observational Studies ◽  
Meta Analysis ◽  
Local Treatment ◽  
Cochrane Library ◽  
Tumor Control ◽  
Comparison Results

Abstract Background and purpose Stereotactic body radiotherapy (SBRT) is a promising ablative modality for hepatocellular carcinoma (HCC) especially for those with small-sized or early-stage tumors. This study aimed to synthesize available data to evaluate efficacy and explore related predictors of SBRT for small liver-confined HCC (≤ 3 lesions with longest diameter ≤ 6 cm). Materials and methods A systematic search were performed of the PubMed and Cochrane Library databases. Primary endpoints were overall survival (OS) and local control (LC) of small HCC treated with SBRT, meanwhile, to evaluate clinical parameters associated with treatment outcome by two methods including subgroup comparisons and pooled HR meta-analysis. The secondary endpoint was treatment toxicity. Results After a comprehensive database review, 14 observational studies with 1238 HCC patients received SBRT were included. Pooled 1-year and 3-year OS rates were 93.0% (95% confidence interval [CI] 88.0–96.0%) and 72.0% (95% CI 62.0–79.0%), respectively. Pooled 1-year and 3-year LC rates were 96.0% (95% CI 91.0–98.0%) and 91.0% (95% CI 85.0–95.0%), respectively. Subgroup comparisons regarding Child–Pugh class (stratified by CP-A percentage 100%, 75–100%, 50–75%) showed there were statistically significant differences for both 1-year and 3-year OS rate (p < 0.01), while that regarding number of lesions, pretreatment situation, age (median/mean age of 65), macrovascular invasion, tumor size, and radiation dose (median BED10 of 100 Gy), there were no differences. In subgroup comparisons for LC rate, it showed number of lesions (1 lesion vs. 2–3 lesions) was significantly associated with 1-year LC rate (p = 0.04), though not associated with 3-year LC rate (p = 0.72). In subgroup comparisons categorized by other factors including pretreatment situation, age, CP-A percentage, macrovascular invasion, tumor size, and radiation dose, there were no significant differences for 1- or 3-year LC rate. To further explore the association between CP class and OS, the second method was applied by combining HR and 95% CIs. Results indicated CP-A was predictive of better OS (p = 0.001) with pooled HR 0.31 (95% CIs 0.11–0.88), which was consistent with subgroup comparison results. Concerning adverse effect of SBRT, pooled rates of grade ≥ 3 hepatic complications and RILD were 4.0% (95% CI 2.0–8.0%) and 14.7% (95% CI 7.4–24.7%), respectively. Conclusion The study showed that SBRT was a potent local treatment for small liver-confined HCC conferring excellent OS and LC persisting up to 3 years, even though parts of included patients were pretreated or with macrovascular invasion. CP-A class was a significant predictor of optimal OS, while number of lesions might affect short term tumor control (1-year LC). Tumor size and radiation dose were not vital factors impacting treatment outcome for such small-sized HCC patients. Because of the low quality of observational studies and heterogeneous groups of patients treated with SBRT, further clinical trials should be prospectively investigated in large sample sizes.

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