Pan Su-Rong, Wo Xue-Wen, Zhu Hong-Fang, Xia Feng-Fei
Department of Gastroenterology, Binzhou People's Hospital, Binzhou, China.
Department of Neurology, Binzhou People's Hospital, Binzhou, China.
Wideochir Inne Tech Maloinwazyjne. 2024 Nov 5;19(4):407-413. doi: 10.20452/wiitm.2024.17906. eCollection 2024 Dec 27.
In patients with inoperable intrahepatic cholangiocarcinoma (ICC), both conventional transarterial chemoembolization (cTACE) and drug‑eluting bead TACE (DEB‑TACE) can be employed as therapeutic interventions. However, the relative advantages of these strategies remain to be clarified.
This meta‑analysis was performed to compare the safety and efficacy of DEB‑TACE and cTACE in the treatment of ICC.
A comprehensive search of the Cochrane Library, PubMed, and Wanfang databases was conducted to identify publications that were pertinent to the present meta‑analysis. The primary outcome of interest was the overall survival (OS) rate. Secondary outcomes were progression‑free survival (PFS), disease control rate (DCR), objective response rate (ORR), and adverse event (AE) rate. Heterogeneity was evaluated using the I 2 statistic, while publication bias was assessed with the Egger test.
A total of 6 articles involving 283 and 178 patients who received cTACE and DEB‑TACE treatment, respectively, were included in this study. DEB‑TACE was superior to cTACE in terms of DCR ( = 0.004), PFS ( <0.001), and OS ( = 0.004), despite comparable pooled ORRs. No intergroup differences were observed with respect to AE occurrence. The ORR, DCR, and OS end points showed significant heterogeneity (I2 = 79%, I = 61%, and I = 95%, respectively). Additionally, the OS end point was subject to substantial publication bias (Egger test, = 0.002).
DEB‑TACE was shown to be superior to cTACE with respect to efficacy, while the safety profile of these 2 interventions was similar. Consequently, DEB‑TACE offers additional value in the management of inoperable ICC.
在无法手术切除的肝内胆管癌（ICC）患者中，传统经动脉化疗栓塞术（cTACE）和载药微球经动脉化疗栓塞术（DEB-TACE）均可作为治疗手段。然而，这些策略的相对优势仍有待明确。
本荟萃分析旨在比较DEB-TACE和cTACE治疗ICC的安全性和疗效。
全面检索Cochrane图书馆、PubMed和万方数据库，以确定与本荟萃分析相关的出版物。主要关注的结局是总生存率（OS）。次要结局包括无进展生存期（PFS）、疾病控制率（DCR）、客观缓解率（ORR）和不良事件（AE）发生率。使用I²统计量评估异质性，采用Egger检验评估发表偏倚。
本研究共纳入6篇文章，分别涉及283例接受cTACE治疗的患者和178例接受DEB-TACE治疗的患者。尽管汇总的ORR相当，但在DCR（P = 0.004）、PFS（P <0.001）和OS（P = 0.004）方面，DEB-TACE优于cTACE。在AE发生方面未观察到组间差异。ORR、DCR和OS终点显示出显著的异质性（I²分别为79%、61%和95%）。此外，OS终点存在明显的发表偏倚（Egger检验，P = 0.002）。
在疗效方面，DEB-TACE被证明优于cTACE，而这两种干预措施的安全性相似。因此，DEB-TACE在无法手术切除的ICC管理中具有额外价值。
