Background: To assess the effectiveness and safety of combining ultrasound-guided interventional therapy with radiotherapy (RT) in treating Hepatocellular Carcinoma (HCC). Materials and Methods: Literature was searched in PubMed, Coghlan's database and Web of Science (WOS) up to November 2024 without language restriction. Outcome indicators included complete response (CR), partial response (PR), stable disease (SD), disease progression (PD), 1-year survival rate, and adverse events (AEs). The Cochrane Collaboration tool was utilized to evaluate the risk of bias in the included studies. Statistical analysis was performed based on revman software, and P<0.05 was considered statistically significant. Results: Five studies were included in the analysis, and the overall quality of the studies was high. The combination therapy group demonstrated statistically significant differences compared to the control group in PR (OR=2.14, 95% CI: 1.32–3.48, P=0.002), PD (OR=0.45, 95% CI: 0.27–0.76, P=0.003), and AEs (OR=0.54, 95% CI: 0.35–0.82, P=0.004). No statistically significant differences were observed between the two groups in terms of CR (OR=1.31, 95% CI: 0.24–7.01, P=0.760), SD (OR=0.88, 95% CI: 0.50–1.55, P=0.670), and one-year survival rate (OR=1.62, 95% CI: 0.85–3.09, P=0.140). Conclusion: Ultrasound-guided interventional therapy combined with RT demonstrates certain clinical advantages in the treatment of HCC, particularly in improving PR, reducing PD, and managing AEs. Additional studies are required to confirm its long-term effectiveness and safety.
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