经动脉钇-90 放射性栓塞治疗不可切除的肝内胆管细胞癌：系统评价和荟萃分析。
Transarterial Yttrium-90 Radioembolization for Unresectable Intrahepatic Cholangiocarcinoma: A Systematic Review and Meta-Analysis.
机构信息
Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York.
Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York.
出版信息
J Vasc Interv Radiol. 2022 Jun;33(6):679-686. doi: 10.1016/j.jvir.2022.02.016. Epub 2022 Feb 25.
PURPOSE
To investigate the overall efficacy and survival profile of yttrium-90 (Y) radioembolization for unresectable intrahepatic cholangiocarcinoma (ICC).
MATERIALS AND METHODS
A systematic literature review and meta-analysis was completed using a random-effects model. Studies describing the use of Y for unresectable ICC were included. The disease control rate (DCR), downstaged-to-resectable rate, cancer antigen 19-9 (CA19-9) response rate, pooled median overall survival (OS), pooled median progression-free survival (PFS), and mean reported survival rates ranging from 3 to 36 months were evaluated.
RESULTS
Twenty-one studies detailing a total of 921 patients were included. The overall DCR was 82.3% (95% confidence interval [CI], 76.7%-87.8%; I = 81%). In 11% of the cases, patients were downstaged to being surgically resectable (95% CI, 6.1%-15.9%; I = 78%). The CA19-9 response rate was 67.2% (95% CI, 54.5%-79.8%; I = 60%). From the time of radioembolization, PFS was 7.8 months (95% CI, 4.2-11.3 months; I = 94%) and median OS was 12.7 months (95% CI, 10.6-14.8 months; I = 62%). Lastly, the mean overall reported survival proportions were 84% at 3 months (standard deviation [SD], 10%), 69% at 6 months (SD, 16%), 47% at 12 months (SD, 19%), 31% at 18 months (SD, 21%), 30% at 24 months (SD, 19%), 21% at 30 months (SD, 27%), and 5% at 36 months (SD, 7%).
CONCLUSIONS
Radioembolization with Y for unresectable ICC results in substantial downstaging, disease control, and survival.
目的
研究钇-90（Y）放射性栓塞治疗不可切除的肝内胆管癌（ICC）的总体疗效和生存情况。
材料和方法
采用随机效应模型进行系统文献回顾和荟萃分析。纳入描述 Y 用于不可切除 ICC 的研究。评估疾病控制率（DCR）、降期至可切除率、癌抗原 19-9（CA19-9）反应率、总体中位生存时间（OS）、中位无进展生存时间（PFS）和 3 至 36 个月的平均报告生存率。
结果
21 项研究共纳入 921 例患者。总体 DCR 为 82.3%（95%置信区间[CI]，76.7%-87.8%；I = 81%）。11%的患者降期为可手术切除（95%CI，6.1%-15.9%；I = 78%）。CA19-9 反应率为 67.2%（95%CI，54.5%-79.8%；I = 60%）。自放射性栓塞治疗起，PFS 为 7.8 个月（95%CI，4.2-11.3 个月；I = 94%），中位 OS 为 12.7 个月（95%CI，10.6-14.8 个月；I = 62%）。最后，3 个月的总体报告生存率均值为 84%（标准差[SD]，10%），6 个月为 69%（SD，16%），12 个月为 47%（SD，19%），18 个月为 31%（SD，21%），24 个月为 30%（SD，19%），30 个月为 21%（SD，27%），36 个月为 5%（SD，7%）。
结论
钇-90 放射性栓塞治疗不可切除的 ICC 可显著降期、控制疾病和提高生存率。
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