Julien Edeline1, Angela Lamarca2, Mairéad G McNamara3, Timothy Jacobs4, Richard A Hubner2, Dan Palmer5, Bas Groot Koerkamp6, Philip Johnson5, Boris Guiu7, Juan W Valle3. 1. Department of Medical Oncology, Centre Eugène Marquis, Rennes, France. Electronic address: j.edeline@rennes.unicancer.fr. 2. Department of Medical Oncology, The Christie NHS Foundation, Manchester/Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom. 3. Division of Cancer Sciences, University of Manchester/Department of Medical Oncology, Manchester, United Kingdom. 4. The Library, The Christie NHS Foundation Trust, Manchester, United Kingdom. 5. University of Liverpool, Liverpool, United Kingdom. 6. Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, Netherlands. 7. Departement of Radiology, St-Eloi University Hospital, Montpellier, France.
Abstract
BACKGROUND: Locoregional treatments (LRT) including radioembolisation (SIRT), transarterial chemo-embolisation (TACE), hepatic arterial infusion (HAI) of chemotherapy, external beam radiotherapy (EBRT) and ablation have been studied for the management of intrahepatic cholangiocarcinoma (iCC). The aim of this systematic review was to provide outcome benchmarks for clinical trial design. METHODS: Identification of studies reporting outcomes of patients treated with LRT for iCC was performed using PubMed and Embase. Pooled weighted means were calculated for progression-free survival (PFS) and overall survival (OS); meta-analysis of proportions was used for estimation of pooled response rate. RESULTS: 6325 entries were reviewed; 93 studies were eligible, representing 101 cohorts and 3990 patients: 15 cohorts (645 patients) for ablation, 18 cohorts (541 patients) for EBRT, 27 cohorts (1232 patients) for SIRT, 22 cohorts (1145 patients) for TACE, 16 cohorts (331 patients) for HAI and 3 cohorts (96 patients) not pooled. 74% of the studies were retrospective, 99% non-randomised. The pooled mean weighted OS was 30.2 months (95% confidence interval (CI): 21.8-38.6) for ablation, 18.9 (14.2-23.5) for EBRT, 14.1 (12.1-16.0) for SIRT, 15.9 (12.9-19.0) for TACE and 21.3 (15.4-27.1) for HAI. The pooled complete response rate was 93.9% for ablation. When analysed together, SIRT, TACE and HAI had a pooled mean weighted OS of 15.7 months, and 25.2 months for patients treated in first-line with concomitant systemic chemotherapy. CONCLUSIONS: Available literature on LRT for iCC was heterogeneous and of insufficient quality to make strong recommendations. Ablation achieved satisfactory outcomes, and may be recommended when surgery is not feasible.
BACKGROUND: Locoregional treatments (LRT) including radioembolisation (SIRT), transarterial chemo-embolisation (TACE), hepatic arterial infusion (HAI) of chemotherapy, external beam radiotherapy (EBRT) and ablation have been studied for the management of intrahepatic cholangiocarcinoma (iCC). The aim of this systematic review was to provide outcome benchmarks for clinical trial design. METHODS: Identification of studies reporting outcomes of patients treated with LRT for iCC was performed using PubMed and Embase. Pooled weighted means were calculated for progression-free survival (PFS) and overall survival (OS); meta-analysis of proportions was used for estimation of pooled response rate. RESULTS: 6325 entries were reviewed; 93 studies were eligible, representing 101 cohorts and 3990 patients: 15 cohorts (645 patients) for ablation, 18 cohorts (541 patients) for EBRT, 27 cohorts (1232 patients) for SIRT, 22 cohorts (1145 patients) for TACE, 16 cohorts (331 patients) for HAI and 3 cohorts (96 patients) not pooled. 74% of the studies were retrospective, 99% non-randomised. The pooled mean weighted OS was 30.2 months (95% confidence interval (CI): 21.8-38.6) for ablation, 18.9 (14.2-23.5) for EBRT, 14.1 (12.1-16.0) for SIRT, 15.9 (12.9-19.0) for TACE and 21.3 (15.4-27.1) for HAI. The pooled complete response rate was 93.9% for ablation. When analysed together, SIRT, TACE and HAI had a pooled mean weighted OS of 15.7 months, and 25.2 months for patients treated in first-line with concomitant systemic chemotherapy. CONCLUSIONS: Available literature on LRT for iCC was heterogeneous and of insufficient quality to make strong recommendations. Ablation achieved satisfactory outcomes, and may be recommended when surgery is not feasible.
Authors: Yi-Te Lee; Amit G Singal; Marie Lauzon; Vatche G Agopian; Michael Luu; Mazen Noureddin; Tsuyoshi Todo; Irene K Kim; Marc L Friedman; Kambiz Kosari; Nicholas N Nissen; Lewis R Roberts; Julie K Heimbach; Gregory J Gores; Ju Dong Yang Journal: Cancer Date: 2022-08-23 Impact factor: 6.921
Authors: Camille Goislard de Monsabert; Yann Touchefeu; Boris Guiu; Boris Campillo-Gimenez; Olivier Farges; David Tougeron; Isabelle Baumgaertner; Ahmet Ayav; Luc Beuzit; Marc Pracht; Astrid Lièvre; Samuel Le Sourd; Karim Boudjema; Yan Rolland; Etienne Garin; Eveline Boucher; Julien Edeline Journal: Curr Oncol Date: 2021-11-08 Impact factor: 3.677