Liu Peng, Ye Haiyan, Song Lijun, Li Hua, Fu Mingna, Dong Zhichao
Department of Radiotherapy, Yantai Yuhuangding Hospital, Yantai, China.
Department of Oncology, Laizhou People's Hospital, Yantai, China.
PeerJ. 2025 Aug 28;13:e19909. doi: 10.7717/peerj.19909. eCollection 2025.
Stereotactic body radiotherapy (SBRT) is an effective treatment for various malignancies. This meta-analysis aimed to determine the prognostic outcomes and toxicities of SBRT for unresectable cholangiocarcinoma (CC) using the most recent evidence.
The review protocol was registered on PROSPERO (CRD42023393642). We searched PubMed, EMBASE, and the Cochrane Library for studies involving SBRT and CC. Study endpoints included median overall survival (OS), 1- and 2-year OS rates, 1- and 2-year disease control rates (DCR), and the incidence of grade 3 or higher toxicities.
Thirteen studies (366 patients) were included. Of these, 138 patients (37.7%) had extrahepatic CC and 228 patients (62.3%) had intrahepatic CC. The median total SBRT dose was 45 Gy, and the median biologically effective dose (BED) was 72.0 Gy. The pooled median OS was 13.4 months (95% confidence interval (CI) [10.9-15.8]). Pooled 1-year and 2-year OS rates were 58.7% (95% CI [53.8-63.7%]) and 33.2% (95% CI [28.3-38.2%]), respectively. Pooled 1-year and 2-year DCR rates were 84.7% (95% CI [81.0-88.3%]) and 70.5% (95% CI [65.2-75.8%]), respectively. Pooled incidence rates for grade ≥3 acute, late, and overall toxicity were 6.4% (95% CI [2.6-10.1%]), 16.4% (95% CI [1.9-31.0%]), and 16.9% (95% CI [9.3-24.6%]), respectively. No factor was significantly associated with improved OS or DCR.
This meta-analysis demonstrates that SBRT may be an efficacious and safe therapeutic option for unresectable CC. Further prospective studies comparing SBRT with alternative treatment approaches are required to define its definitive role in managing CC.
立体定向体部放疗（SBRT）是治疗多种恶性肿瘤的有效方法。本荟萃分析旨在利用最新证据确定SBRT治疗不可切除胆管癌（CC）的预后结果和毒性。
该综述方案已在PROSPERO（CRD42023393642）上注册。我们在PubMed、EMBASE和Cochrane图书馆中检索了涉及SBRT和CC的研究。研究终点包括中位总生存期（OS）、1年和2年总生存率、1年和2年疾病控制率（DCR）以及3级或更高等级毒性的发生率。
纳入了13项研究（366例患者）。其中，138例患者（37.7%）患有肝外CC，228例患者（62.3%）患有肝内CC。SBRT的中位总剂量为45 Gy，中位生物等效剂量（BED）为72.0 Gy。汇总的中位OS为13.4个月（95%置信区间（CI）[10.9 - 15.8]）。1年和2年总生存率分别为58.7%（95% CI [53.8 - 63.7%]）和33.2%（95% CI [28.3 - 38.2%]）。1年和2年DCR率分别为84.7%（95% CI [81.0 - 88.3%]）和70.5%（95% CI [65.2 - 75.8%]）。3级及以上急性、晚期和总体毒性的汇总发生率分别为6.4%（95% CI [2.6 - 10.1%]）、16.4%（95% CI [1.9 - 31.0%]）和16.9%（95% CI [9.3 - 24.6%]）。没有因素与OS或DCR的改善显著相关。
本荟萃分析表明，SBRT可能是不可切除CC的一种有效且安全的治疗选择。需要进一步进行前瞻性研究，将SBRT与其他治疗方法进行比较，以确定其在CC治疗中的明确作用。
