Locoregional therapies in patients with intrahepatic cholangiocarcinoma: A systematic review and pooled analysis
McNamara, Mairead G
Hubner, Richard A
Groot Koerkamp, B.
Valle, Juan W
AffiliationDepartment of Medical Oncology, Centre Eugène Marquis, Rennes, France.
MetadataShow full item record
AbstractBackground: 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.
CitationEdeline 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.
JournalCancer Treatment Reviews
- Comparative effectiveness of hepatic artery based therapies for unresectable intrahepatic cholangiocarcinoma.
- Authors: Boehm LM, Jayakrishnan TT, Miura JT, Zacharias AJ, Johnston FM, Turaga KK, Gamblin TC
- Issue date: 2015 Feb
- Surgical Resection Does Not Improve Survival in Multifocal Intrahepatic Cholangiocarcinoma: A Comparison of Surgical Resection with Intra-Arterial Therapies.
- Authors: Wright GP, Perkins S, Jones H, Zureikat AH, Marsh JW, Holtzman MP, Zeh HJ 3rd, Bartlett DL, Pingpank JF Jr
- Issue date: 2018 Jan
- Locoregional therapy for cholangiocarcinoma.
- Authors: Kuhlmann JB, Blum HE
- Issue date: 2013 May
- Locoregional options in the management of cholangiocarcinoma: single center experience.
- Authors: Baydoun H, Meirovich H, Maroun G, Coburn N, David E
- Issue date: 2021 Feb
- Locoregional Therapy of Hepatocellular-Cholangiocarcinoma versus Hepatocellular Carcinoma: A Propensity Score-Matched Study.
- Authors: Huang YH, Park BV, Chen YF, Gaba RC, Guzman G, Lokken RP
- Issue date: 2019 Sep