Locoregional therapies in patients with intrahepatic cholangiocarcinoma: A systematic review and pooled analysis

BackgroundLocoregional 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 intrahepatic cholangiocarcinoma (iCC). The aim this systematic review was to provide outcome benchmarks clinical trial design.MethodsIdentification studies reporting outcomes patients treated with LRT iCC performed using PubMed Embase. Pooled weighted means were calculated progression-free survival (PFS) overall (OS); meta-analysis proportions used estimation pooled response rate.Results6325 entries reviewed; 93 eligible, representing 101 cohorts 3990 patients: 15 (645 patients) ablation, 18 (541 EBRT, 27 (1232 SIRT, 22 (1145 TACE, 16 (331 HAI 3 (96 not pooled. 74% retrospective, 99% non-randomised.The mean OS 30.2 months (95% confidence interval (CI): 21.8–38.6) 18.9 (14.2–23.5) 14.1 (12.1–16.0) 15.9 (12.9–19.0) TACE 21.3 (15.4–27.1) HAI. complete rate 93.9% ablation. When analysed together, had a 15.7 months, 25.2 in first-line concomitant systemic chemotherapy.ConclusionsAvailable literature on heterogeneous insufficient quality make strong recommendations. Ablation achieved satisfactory outcomes, may be recommended when surgery is feasible.