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系统化疗联合热消融治疗不可切除的肝内胆管细胞癌:倾向评分匹配分析。

Addition of thermal ablation to systemic chemotherapy for the treatment of unresectable intrahepatic cholangiocarcinoma: a propensity score matching analysis.

机构信息

Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

Cancer minimally invasive treatment center, Fudan University Shanghai Cancer Center, Shanghai, China.

出版信息

Expert Rev Gastroenterol Hepatol. 2022 Jan;16(1):81-88. doi: 10.1080/17474124.2022.2021067. Epub 2021 Dec 31.

Abstract

OBJECTIVES

To retrospectively compare the survival outcomes of thermal ablation plus chemotherapy to those of chemotherapy alone in patients with unresectable intrahepatic cholangiocarcinoma (ICC).

METHODS

189 patients with unresectable ICC who received thermal ablation plus chemotherapy or chemotherapy alone as the initial treatment were identified . To avoid potential bias, 1:1 matching between groups was performed through propensity score matching. Overall survival (OS) was the primary endpoint. Clinical and tumor factors related to OS were analyzed through univariate and multivariate analyses.

RESULTS

Of the enrolled patients, 55 received ablation plus chemotherapy, and 134 received chemotherapy alone. The median OS was 16.267 months for patients treated with combined therapy and 6.067 months for patients treated with chemotherapy alone (p = 0.000). The benefit of ablation plus chemotherapy was also preserved in the matched cohort, with a median OS of 15.233 months in the combined treatment group and 7.967 months in the chemotherapy group (p = 0.009). Univariate and multivariate analyses indicated that the type of treatment was an independent factor of OS (p < 0.05).

CONCLUSIONS

The combination of thermal ablation and systemic chemotherapy provides an opportunity to improve the prognosis of patients with unresectable ICC.

摘要

目的

回顾性比较不可切除的肝内胆管细胞癌(ICC)患者接受热消融联合化疗与单纯化疗的生存结局。

方法

共纳入 189 例接受热消融联合化疗或单纯化疗作为初始治疗的不可切除 ICC 患者。为避免潜在偏倚,通过倾向评分匹配对两组进行 1:1 匹配。总生存期(OS)是主要终点。通过单因素和多因素分析,对与 OS 相关的临床和肿瘤因素进行分析。

结果

在纳入的患者中,55 例接受消融联合化疗,134 例接受单纯化疗。联合治疗组的中位 OS 为 16.267 个月,单纯化疗组为 6.067 个月(p=0.000)。在匹配队列中,消融联合化疗的获益也得以保留,联合治疗组的中位 OS 为 15.233 个月,化疗组为 7.967 个月(p=0.009)。单因素和多因素分析表明,治疗方式是 OS 的独立影响因素(p<0.05)。

结论

热消融联合全身化疗为不可切除 ICC 患者提供了改善预后的机会。

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