Locoregional therapy combined with systemic therapy (LRT + ST) for unresectable intrahepatic cholangiocarcinoma: A systematic review and meta-analysis

LRT+ST for unresectable iCCA

Authors

  • Mengqi Zhang The Affiliated Hospital of Qingdao University https://orcid.org/0000-0003-4919-8786
  • Weiwei Qi The Affiliated Hospital of Qingdao University
  • Xiaofei Qiu Qingdao Municipal Center For Disease Control&Prevention
  • Chunpeng Yu The Affiliated Hospital of Qingdao University
  • Wensheng Qiu The Affiliated Hospital of Qingdao University
  • Song Wang The Affiliated Hospital of Qingdao University
  • Zhenkang Qiu The Affiliated Hospital of Qingdao University https://orcid.org/0000-0001-8727-5178

Abstract

Background: The outcome of systemic therapy (ST) for unresectable intrahepatic cholangiocarcinoma (iCCA) is poor. This study aims to further evaluate the efficacy and safety of locoregional therapy combined with systemic therapy (LRT + ST) compared with only ST in unresectable iCCA by performing a systematic literature review and meta-analysis.

Methods: A comprehensive search was performed in PubMed, Web of Science, EMBASE, and the Cochrane Library up to November 3, 2022. The primary outcome was overall survival (OS), and the secondary outcomes were progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs).

Results: Ten retrospective cohort studies with 3,791 unresectable iCCA patients were enrolled in this study, including 1,120 who received ablation, arterially directed therapy (ADT), or external beam radiation therapy (EBRT) combined with ST. The meta-analysis showed that the LRT + ST group had a better OS (HR = 0.51; 95% CI = 0.41–0.64; p value < 0.001), PFS (HR = 0.40, 95% CI = 0.22–0.71, p value = 0.002) and ORR (RR = 1.68; 95% CI = 1.17–2.42; p value = 0.005). Subgroup analysis showed that both ST combined with ADT (HR = 0.42, 95% CI = 0.31–0.56, p value < 0.001) and EBRT (HR = 0.67, 95% CI = 0.63–0.72, p value < 0.001) could improve OS. Neutropenia, thrombocytopenia, anemia, anorexia, and vomiting did not show significant differences between the groups (p value > 0.05).

Conclusion: Compared with only ST, LRT + ST improved survival outcomes for unresectable iCCA patients without increasing severe AEs, which can further provide a basis for guidelines.

Downloads

Additional Files

Published

2023-11-27

How to Cite

Zhang, M., Qi, W., Qiu, X., Yu, C., Qiu, W., Wang, S., & Qiu, Z. (2023). Locoregional therapy combined with systemic therapy (LRT + ST) for unresectable intrahepatic cholangiocarcinoma: A systematic review and meta-analysis: LRT+ST for unresectable iCCA. Radiology and Oncology, 57(4), 419–429. Retrieved from https://radioloncol.com/index.php/ro/article/view/4115

Issue

Section

Review