探讨钇90(90Y)放射性栓塞治疗不可切除肝内胆管癌(ICC)的总体疗效和生存情况。
使用随机效应模型完成了系统的文献综述和荟萃分析。包括描述90Y用于不可切除的ICC的研究。疾病控制率(DCR),降至可切除率,癌抗原19-9(CA19-9)应答率,汇总中位总生存期(OS),汇总中位无进展生存期(PFS),评估了3~36个月的平均报告生存率.
纳入了21项研究,详细介绍了总共921名患者。总DCR为82.3%(95%置信区间[CI],76.7%-87.8%;I2=81%)。在11%的案例中,患者降期至可手术切除(95%CI,6.1%-15.9%;I2=78%).CA19-9反应率为67.2%(95%CI,54.5%-79.8%;I2=60%)。从放射栓塞开始,PFS为7.8个月(95%CI,4.2-11.3个月;I2=94%),中位OS为12.7个月(95%CI,10.6-14.8个月;I2=62%)。最后,3个月时报告的平均总生存率为84%(标准偏差[SD],10%),6个月时为69%(SD,16%),12个月时为47%(SD,19%),18个月时为31%(SD,21%),24个月时30%(SD,19%),30个月时为21%(SD,27%),36个月时为5%(SD,7%)。
使用90Y进行不可切除的ICC的放射栓塞会导致大幅降低分期,疾病控制,和生存。
To investigate the overall efficacy and survival profile of yttrium-90 (90Y) radioembolization for unresectable intrahepatic cholangiocarcinoma (ICC).
A systematic literature
review and meta-analysis was completed using a random-effects model. Studies describing the use of 90Y 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.
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%; I2 = 81%). In 11% of the cases, patients were downstaged to being surgically resectable (95% CI, 6.1%-15.9%; I2 = 78%). The CA19-9 response rate was 67.2% (95% CI, 54.5%-79.8%; I2 = 60%). From the time of radioembolization, PFS was 7.8 months (95% CI, 4.2-11.3 months; I2 = 94%) and median OS was 12.7 months (95% CI, 10.6-14.8 months; I2 = 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%).
Radioembolization with 90Y for unresectable ICC results in substantial downstaging, disease control, and survival.