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

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

Open Access
|Nov 2023

Figures & Tables

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

StudyCountryTreatmentSampleAge (years)Sex (F:M)Outcomes

LRT + ST STLRT + STSTLRT + STSTLRT + STST
Yang, 202220ChinaADT: DEB-TACE (Doxorubicin)ICIs (Camrelizumab or Sintilimab)Gemcitabine + Cisplatin202059599:117:13OS, PFS, ORR, AEs
Yan, 202221ChinaAblation: RFA / MWAGemcitabine*Gemcitabine*3636NRNR14:2215:21OS
Sun, 202122ChinaADT: TACI (5-Fluoruracil + cisplatin)Gemcitabine + S-1Gemcitabine + Cisplatin + S-13333NRNRNRNROS, PFS, ORR, AEs
Gairing, 202123GermanyADT: TACE (Mitomycin C / Doxorubicin)Gemcitabine*Gemcitabine*145961.366.88:629:30OS
Hu, 202024ChinaADT: DEB-TACE (Gemcitabine + Cisplatin) / cTACE (Gemcitabine + Cisplatin + lipiodol)ApatinibApatinib131055.958.77:62:8OS, PFS, ORR, AEs
Verma, 201825,&AmericaEBRTSYSSYS66621766565309:3571095:1081OS
Chang, 201826,&ChinaEBRT: CCRT / CTRTFluoropyrimidine* / Gemcitabine*Fluoropyrimidine* / Gemcitabine*21121160.1160.8081:13084:127OS
Konstantinidis, 201627AmericaADT: HAI (Floxuridine*)Gemcitabine* / Irinotecan* / 5-Fluoruracil*Gemcitabine* / 5-Fluoruracil*7826622647:3113:13OS, ORR
Edeline, 201528,&FranceADT: 90Y SIRTGemcitabine* / 5-Fluoruracil*Gemcitabine + Cisplatin#2433NRNRNRNROS, PFS
Kim, 201329KoreaEBRT: CCRTCapecitabine + CisplatinCapecitabine + Cisplatin256756586:1914:53OS, PFS, ORR, AEs
DOI: https://doi.org/10.2478/raon-2023-0059 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 419 - 429
Submitted on: Jun 1, 2023
Accepted on: Sep 18, 2023
Published on: Nov 30, 2023
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2023 Mengqi Zhang, Weiwei Qi, Xiaofei Qiu, Chunpeng Yu, Wensheng Qiu, Song Wang, Zhenkang Qiu, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.