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

Mengqi Zhang
Mengqi Zhang
, 
Weiwei Qi
Weiwei Qi
, 
Xiaofei Qiu
Xiaofei Qiu
, 
Chunpeng Yu
Chunpeng Yu
, 
Wensheng Qiu
Wensheng Qiu
, 
Song Wang
Song Wang
 und 
Zhenkang Qiu
Zhenkang Qiu
   | 30. Nov. 2023
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Article Category: Review
Online veröffentlicht: 30. Nov. 2023
Seitenbereich: 419 - 429
Eingereicht: 01. Juni 2023
Akzeptiert: 18. Sept. 2023
DOI: https://doi.org/10.2478/raon-2023-0059
Schlüsselwörter
© 2023 Mengqi Zhang et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

Systematic Reviews and Meta-Analyses (PRISMA) flow chart.
Systematic Reviews and Meta-Analyses (PRISMA) flow chart.

FIGURE 2.

Forest plots for overall survival (OS) in unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) patients treated by locoregional therapy combined with systemic therapy versus only systemic therapy.95% CI = 95% confidence intervals; DL = DerSimonian–Laird method; HR = hazard ratio; IV = inverse variance method
Forest plots for overall survival (OS) in unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) patients treated by locoregional therapy combined with systemic therapy versus only systemic therapy.95% CI = 95% confidence intervals; DL = DerSimonian–Laird method; HR = hazard ratio; IV = inverse variance method

FIGURE 3.

Subgroup analysis of overall survival (OS) in unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) patients according to types of locoregional therapy combined with systemic therapy (ablation, ADT, RT). 95% CI = 95% confidence intervals.ADT = arterially directed therapy; DL = DerSimonian–Laird method; HR = hazard ratio; IV = inverse variance method; EBRT= external beam radiation therapy
Subgroup analysis of overall survival (OS) in unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) patients according to types of locoregional therapy combined with systemic therapy (ablation, ADT, RT). 95% CI = 95% confidence intervals.ADT = arterially directed therapy; DL = DerSimonian–Laird method; HR = hazard ratio; IV = inverse variance method; EBRT= external beam radiation therapy

FIGURE 4.

Forest plots for progression-free survival (PFS) in unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) patients treated by locoregional therapy combined with systemic therapy versus only systemic therapy.95% CI = 95% confidence intervals; DL = DerSimonian–Laird method; HR = hazard ratio; IV = inverse variance method
Forest plots for progression-free survival (PFS) in unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) patients treated by locoregional therapy combined with systemic therapy versus only systemic therapy.95% CI = 95% confidence intervals; DL = DerSimonian–Laird method; HR = hazard ratio; IV = inverse variance method

FIGURE 5.

Forest plots for objective response rate (ORR) in unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) patients treated by locoregional therapy combined with systemic therapy (LRT + ST) versus only systemic therapy (ST).95% CI = 95% confidence intervals; MH = Mantel–Haenszel model; RR = relative risk.
Forest plots for objective response rate (ORR) in unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) patients treated by locoregional therapy combined with systemic therapy (LRT + ST) versus only systemic therapy (ST).95% CI = 95% confidence intervals; MH = Mantel–Haenszel model; RR = relative risk.

FIGURE 6.

Forest plots for the incidence of neutropenia (A), thrombocytopenia (B), anemia (C), anorexia (D), and vomiting (E) in unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) patients treated by locoregional therapy combined with systemic therapy (LRT + ST) versus only systemic therapy (ST).95% CI = 95% confidence intervals; DL = DerSimonian–Laird method; MH = Mantel–Haenszel model; RR = relative risk.
Forest plots for the incidence of neutropenia (A), thrombocytopenia (B), anemia (C), anorexia (D), and vomiting (E) in unresectable and metastatic intrahepatic cholangiocarcinoma (iCCA) patients treated by locoregional therapy combined with systemic therapy (LRT + ST) versus only systemic therapy (ST).95% CI = 95% confidence intervals; DL = DerSimonian–Laird method; MH = Mantel–Haenszel model; RR = relative risk.

Main study characteristics of included studies

Study Country Treatment Sample Age (years) Sex (F:M) Outcomes
LRT + ST ST LRT + ST ST LRT + ST ST LRT + ST ST
Yang, 202220 China ADT: DEB-TACE (Doxorubicin) ICIs (Camrelizumab or Sintilimab) Gemcitabine + Cisplatin 20 20 59 59 9:11 7:13 OS, PFS, ORR, AEs
Yan, 202221 China Ablation: RFA / MWA Gemcitabine* Gemcitabine* 36 36 NR NR 14:22 15:21 OS
Sun, 202122 China ADT: TACI (5-Fluoruracil + cisplatin) Gemcitabine + S-1 Gemcitabine + Cisplatin + S-1 33 33 NR NR NR NR OS, PFS, ORR, AEs
Gairing, 202123 Germany ADT: TACE (Mitomycin C / Doxorubicin) Gemcitabine* Gemcitabine* 14 59 61.3 66.8 8:6 29:30 OS
Hu, 202024 China ADT: DEB-TACE (Gemcitabine + Cisplatin) / cTACE (Gemcitabine + Cisplatin + lipiodol) Apatinib Apatinib 13 10 55.9 58.7 7:6 2:8 OS, PFS, ORR, AEs
Verma, 201825,& America EBRT SYS SYS 666 2176 65 65 309:357 1095:1081 OS
Chang, 201826,& China EBRT: CCRT / CTRT Fluoropyrimidine* / Gemcitabine* Fluoropyrimidine* / Gemcitabine* 211 211 60.11 60.80 81:130 84:127 OS
Konstantinidis, 201627 America ADT: HAI (Floxuridine*) Gemcitabine* / Irinotecan* / 5-Fluoruracil* Gemcitabine* / 5-Fluoruracil* 78 26 62 26 47:31 13:13 OS, ORR
Edeline, 201528,& France ADT: 90Y SIRT Gemcitabine* / 5-Fluoruracil* Gemcitabine + Cisplatin# 24 33 NR NR NR NR OS, PFS
Kim, 201329 Korea EBRT: CCRT Capecitabine + Cisplatin Capecitabine + Cisplatin 25 67 56 58 6:19 14:53 OS, PFS, ORR, AEs
eISSN:
1581-3207
Sprache:
Englisch
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4 Hefte pro Jahr
Fachgebiete der Zeitschrift:
Medizin, Klinische Medizin, Allgemeinmedizin, Innere Medizin, Hämatologie, Onkologie, Radiologie
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