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    Locoregional therapies in patients with intrahepatic cholangiocarcinoma: A systematic review and pooled analysis

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    Authors
    Edeline, J.
    Lamarca, Angela
    McNamara, Mairead G
    Jacobs, Timothy
    Hubner, Richard A
    Palmer, D.
    Groot Koerkamp, B.
    Johnson, P.
    Guiu, B
    Valle, Juan W
    Affiliation
    Department of Medical Oncology, Centre Eugène Marquis, Rennes, France.
    Issue Date
    2021
    
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    Abstract
    Background: Locoregional treatments (LRT) including radioembolisation (SIRT), transarterial chemo-embolisation (TACE), hepatic arterial infusion (HAI) of chemotherapy, external beam radiotherapy (EBRT) and ablation have been studied for the management of intrahepatic cholangiocarcinoma (iCC). The aim of this systematic review was to provide outcome benchmarks for clinical trial design. Methods: Identification of studies reporting outcomes of patients treated with LRT for iCC was performed using PubMed and Embase. Pooled weighted means were calculated for progression-free survival (PFS) and overall survival (OS); meta-analysis of proportions was used for estimation of pooled response rate. Results: 6325 entries were reviewed; 93 studies were eligible, representing 101 cohorts and 3990 patients: 15 cohorts (645 patients) for ablation, 18 cohorts (541 patients) for EBRT, 27 cohorts (1232 patients) for SIRT, 22 cohorts (1145 patients) for TACE, 16 cohorts (331 patients) for HAI and 3 cohorts (96 patients) not pooled. 74% of the studies were retrospective, 99% non-randomised. The pooled mean weighted OS was 30.2 months (95% confidence interval (CI): 21.8-38.6) for ablation, 18.9 (14.2-23.5) for EBRT, 14.1 (12.1-16.0) for SIRT, 15.9 (12.9-19.0) for TACE and 21.3 (15.4-27.1) for HAI. The pooled complete response rate was 93.9% for ablation. When analysed together, SIRT, TACE and HAI had a pooled mean weighted OS of 15.7 months, and 25.2 months for patients treated in first-line with concomitant systemic chemotherapy. Conclusions: Available literature on LRT for iCC was heterogeneous and of insufficient quality to make strong recommendations. Ablation achieved satisfactory outcomes, and may be recommended when surgery is not feasible.
    Citation
    Edeline J, Lamarca A, McNamara MG, Jacobs T, Hubner RA, Palmer D, et al. Locoregional therapies in patients with intrahepatic cholangiocarcinoma: A systematic review and pooled analysis. Cancer Treatment Reviews. 2021 Sep;99:102258.
    Journal
    Cancer Treatment Reviews
    URI
    http://hdl.handle.net/10541/624441
    DOI
    10.1016/j.ctrv.2021.102258
    PubMed ID
    34252720
    Additional Links
    https://dx.doi.org/10.1016/j.ctrv.2021.102258
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ctrv.2021.102258
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